腰丛神经阻滞与硬膜外麻醉对老年股骨粗隆骨折患者的麻醉效果观察

Effect of Lumbar Plexus Block and Epidural Anesthesia on Elderly Patients with Femoral Trochanteric Fracture

目的:观察与研究老年股骨粗隆骨折治疗中腰丛神经阻滞与硬膜外麻醉的效果.方法:选取2019年6月—2021年6月我院收治的78例行手术治疗的老年股骨粗隆骨折患者为研究对象;按照随机颜色球抽取法分为参照组和试验组,各39例.参照组采用硬膜外麻醉,试验组采用腰丛神经阻滞麻醉,对2组患者麻醉前、麻醉后平均动脉压(MAP)、心率(HR)及麻醉后不良反应的发生情况,患者的手术情况,进行对比与分析.结果:麻醉后,试验组MAP、不良反应发生率均低于参照组,HR慢于参照组,组间差异有统计学意义(P<0.05).试验组患者手术时间、住院时间、术后禁食时间均短于参照组,术中出血量少于参照组,组间差异有统计学意义(P<0.05).结论:在老年股骨粗隆骨折手术治疗中,相较于硬膜外麻醉,腰丛神经阻滞麻醉效果更佳,不仅不会对患者血流动力学造成太大影响,同时还可以大大降低患者术后不良反应的发生,还有助于改善患者手术情况.

Objective:To observe and study the effect of lumbar plexus block and epidural anesthesia in the treatment of femoral intertrochanteric fracture in the elderly.Methods:78 elderly patients with femoral intertrochanteric fractures who underwent surgical treatment in our hospital from June 2019 to June 2021 were selected as the research objects.According to the random color ball extraction method,they were divided into a reference group and an experimental group,with 39 cases in each group.The reference group was treated with epidural anesthesia,and the experimental group was treated with lumbar plexus block anesthesia.The mean arterial pressure(MAP)and heart rate(HR)before and after anesthesia,the occurrence of adverse reactions after anesthesia,and the operation of patients in the two groups were compared and analyzed.Results:After anesthesia,the MAP,and incidence of adverse reactions in the experimental group were lower than those in the reference group,the HR was slower than that in the reference group,and the differences between the two groups were statistically significant(P<0.05).The operation time,hospitalization time and postoperative fasting time of the experimental group were shorter than those of the reference group,and the intraoperative blood loss was less than that of the reference group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:In the surgical treatment of femoral intertrochanteric fracture in the elderly,lumbar plexus block anesthesia has better effect than epidural anesthesia.It not only does not have much impact on hemodynamics,but also can greatly reduce the occurrence of postoperative adverse reactions,and is helpful to improve the surgical condition of patients.