目的探讨高位肌间沟罗哌卡因神经阻滞用于老年锁骨骨折麻醉效果及其对应激反应影响。方法选取大连市普兰店区中心医院2018年12月至2019年12月收治的150例老年锁骨骨折手术患者,随机分为对照组与观察组,每组各75例,对照组给予常规肌间沟...目的探讨高位肌间沟罗哌卡因神经阻滞用于老年锁骨骨折麻醉效果及其对应激反应影响。方法选取大连市普兰店区中心医院2018年12月至2019年12月收治的150例老年锁骨骨折手术患者,随机分为对照组与观察组,每组各75例,对照组给予常规肌间沟臂丛神经阻滞麻醉,观察组给予高位肌间沟罗哌卡因神经阻滞麻醉,对比两组患者的麻醉效果、应激反应、术后疼痛及并发症发生率。结果观察组患者麻醉优良率为100.0%,高于对照组的93.33%;麻醉后观察组患者的SVI(45.93±8.78)mL/m^(2)、MAP(82.59±19.52)mmHg、HR(64.93±8.78)次/min,高于对照组的SVI(38.84±13.67)mL/m^(2)、MAP(74.62±6.78)mmHg、HR(60.84±6.67)次/min;术后1 h观察组患者的CI(2.83±0.54)L/(min·m^(2))、MAP(82.53±12.54)mmHg、HR(67.53±8.54)次/min,高于对照组的CI(2.52±0.52)L/(min·m^(2))、MAP(76.53±10.54)mmHg、HR(60.53±4.54)次/min;观察组患者术后2 h VAS评分(3.07±1.02)分、6 h VAS评分(3.00±0.34)分、12 h VAS评分(2.95±0.14)分、24 h VAS评分(1.85±0.22)分,低于对照组患者术后2 h VAS评分(3.68±1.21)分、6 h VAS评分(3.27±0.26)分、12 h VAS评分(3.13±0.25)分、24 h VAS评分(2.51±0.26)分;观察组并发症发生率为9.33%,低于对照组的21.33%(P<0.05)。结论老年骨折手术患者应用高位肌间沟罗哌卡因神经阻滞麻醉效果更好,并可降低患者应激反应发生率。展开更多
Purpose： To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture （Sanders II-IIl） in elderly patients. Methods： From October 2012 to December 2013, 23 elderly patients suffering...Purpose： To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture （Sanders II-IIl） in elderly patients. Methods： From October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture （Sanders Ⅱ-Ⅲ） were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years （range： 65-79 years）. According to Sander＇s classification, 16 cases （16 feet） were type II fractures and 7 cases （7 feet） were type llI fractures. Anteroposterior, lateral and axial views of X-ray were taken to detect the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Radiological assessment was performed using Bohler＇s angle and Gissane＇s angle. Functional outcome was assessed using the Maryland foot score. Results： All the patients were followed up for 13.7 months on average （10-20 months）. The mean time of bone union was 3.2 months （3-4 months）. The mean time of complete weight bearing was 3.2 months （3.1-4.0 months）. The soft tissue necrosis was found in 1 case. The mean Bohler＇s angle and Gissane＇s angle were 25.31° and 117.5° respectively. The overall excellent to good rate was 82.6%. Conclusion： Open reduction and internal fixation with locking calcaneal plate can obtain good functional outcome for Sanders II-III calcaneal fractures in elderly patients.展开更多
文摘目的探讨高位肌间沟罗哌卡因神经阻滞用于老年锁骨骨折麻醉效果及其对应激反应影响。方法选取大连市普兰店区中心医院2018年12月至2019年12月收治的150例老年锁骨骨折手术患者,随机分为对照组与观察组,每组各75例,对照组给予常规肌间沟臂丛神经阻滞麻醉,观察组给予高位肌间沟罗哌卡因神经阻滞麻醉,对比两组患者的麻醉效果、应激反应、术后疼痛及并发症发生率。结果观察组患者麻醉优良率为100.0%,高于对照组的93.33%;麻醉后观察组患者的SVI(45.93±8.78)mL/m^(2)、MAP(82.59±19.52)mmHg、HR(64.93±8.78)次/min,高于对照组的SVI(38.84±13.67)mL/m^(2)、MAP(74.62±6.78)mmHg、HR(60.84±6.67)次/min;术后1 h观察组患者的CI(2.83±0.54)L/(min·m^(2))、MAP(82.53±12.54)mmHg、HR(67.53±8.54)次/min,高于对照组的CI(2.52±0.52)L/(min·m^(2))、MAP(76.53±10.54)mmHg、HR(60.53±4.54)次/min;观察组患者术后2 h VAS评分(3.07±1.02)分、6 h VAS评分(3.00±0.34)分、12 h VAS评分(2.95±0.14)分、24 h VAS评分(1.85±0.22)分,低于对照组患者术后2 h VAS评分(3.68±1.21)分、6 h VAS评分(3.27±0.26)分、12 h VAS评分(3.13±0.25)分、24 h VAS评分(2.51±0.26)分;观察组并发症发生率为9.33%,低于对照组的21.33%(P<0.05)。结论老年骨折手术患者应用高位肌间沟罗哌卡因神经阻滞麻醉效果更好,并可降低患者应激反应发生率。
文摘Purpose： To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture （Sanders II-IIl） in elderly patients. Methods： From October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture （Sanders Ⅱ-Ⅲ） were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years （range： 65-79 years）. According to Sander＇s classification, 16 cases （16 feet） were type II fractures and 7 cases （7 feet） were type llI fractures. Anteroposterior, lateral and axial views of X-ray were taken to detect the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Radiological assessment was performed using Bohler＇s angle and Gissane＇s angle. Functional outcome was assessed using the Maryland foot score. Results： All the patients were followed up for 13.7 months on average （10-20 months）. The mean time of bone union was 3.2 months （3-4 months）. The mean time of complete weight bearing was 3.2 months （3.1-4.0 months）. The soft tissue necrosis was found in 1 case. The mean Bohler＇s angle and Gissane＇s angle were 25.31° and 117.5° respectively. The overall excellent to good rate was 82.6%. Conclusion： Open reduction and internal fixation with locking calcaneal plate can obtain good functional outcome for Sanders II-III calcaneal fractures in elderly patients.
