| 尚磊晶,张蜜,范冬冬,等.入院后即刻连续腰丛神经阻滞镇痛对老年髋关节置换病人加速康复外科的影响[J].安徽医药,2023,27(8):1646-1650. |
| 入院后即刻连续腰丛神经阻滞镇痛对老年髋关节置换病人加速康复外科的影响 |
| Effect of continuous lumbar plexus block analgesia immediately after admission on ERAS in elderly patients undergoing hip arthroplasty |
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| DOI：10.3969/j.issn.1009-6469.2023.08.034 |
| 中文关键词: 股骨颈骨折 麻醉和镇痛 腰骶丛 入院即刻 老年人 髋关节置换 加速康复外科 |
| 英文关键词: Femoral neck fractures Anesthesia and analgesia Lumbosacral plexus Immediately after admission Elderly pa tients Hip replacement Enhanced recovery after surgery |
| 基金项目:安徽理工大学校级重点项目( fsyyzd2020-05) |
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| 中文摘要: |
| 目的研究老年股骨颈骨折病人入院后即刻行连续腰丛阻滞预防性镇痛对住院时间、疼痛的改善程度及住院期间全身情况的影响。方法选取 2021年 1月至 2022年 7月安徽理工大学附属淮南新华医院骨科收治老年股骨颈骨折病人 54例，按入院后即刻镇痛处理情况分为两组:连续腰丛阻滞镇痛组( N组)及常规镇痛药处理组( C组)，各 27例。主要观察指标为病人住院时间；次要观察指标包括术前术后视觉模拟评分( VAS)；入院后睡眠质量；血清炎性指标；术后不良反应发生率；术后髋关节外展活动度和屈曲度；术后切口引流量；首次下床活动时间。结果 N组住院时间［(6.78±0.80)d比(8.96±1.79)d］、术后首次下床活动时间［(41.67±6.83)h比( 56.85±10.00)h］均短于 C组( P<0.05)； N组病人入院即刻阻滞后 30 min静息 VAS评分较阻滞前明显下降( P<0.05)； N组术后的静息及运动 VAS评分明显低于 C组( P<0.05)差异有统计学意义； N组病人入院后术前睡眠质量优于 C组［( 3.59±0.97)分比( 6.59±1.01)分， P<0.05］； N组病人术前术后血清，炎性因子水平、术后切口引流量［( 31.67±10.00)mL比( 70.00±21.79)mL］及术后不良反应发生例数( 5比 15)明显低于 C组(P<0.05)。结论入院后即刻行连续腰丛神经阻滞预防性镇痛，能有效缩短老年股骨颈骨折病人住院时间，降低疼痛程度，降低并发症发生率，促进病人早期快速康复。 |
| 英文摘要: |
| Objective To study the effect of continuous lumbar plexus block prophylactic analgesia on the length of hospital stay,the improvement of pain and the general condition of elderly patients with femoral neck fracture immediately after admission.Meth ods From January 2021 to July 2022, 54 elderly patients with femoral neck fracture treated in the Department of Orthopaedics ofHuainan Xinhua Hospital Affiliated to Anhui University of Technology were randomly divided into two groups according to the immediate analgesic treatment after admission: continuous lumbar plexus block analgesia group (N group, n=27) and conventional analgesics treatment group (C group, n=27). The main outcome measures were the length of stay; Secondary outcome measures included preoperative and postoperative pain score (VAS); Sleep quality after admission; Serum inflammatory index; The incidence of postoperative adverse reactions; Abduction range of motion and flexion of hip joint after operation; Postoperative incision drainage; First time out of bedactivity time.Results The hospitalization time[(6.78±0.80) d vs. (8.96±1.79) d] and the first postoperative ambulation time [(41.67± 6.83) h vs.(56.85±10.00) h] in group N were shorter than those in group C (P<0.05); In group N, the resting VAS score at 30 min after immediate block was significantly lower than that before block (P<0.05);The VAS scores of rest and exercise in group N were signifi cantly lower than those in group C (P<0.05); The preoperative sleep quality of patients in group N was better than that of patients in group C[(3.59±0.97) vs.(6.59±1.01),P<0.05]; The levels of serum inflammatory factors, postoperative incision drainage volume[(31.67± 10.00) mL vs.(70.00±21.79) mL] and the incidence of postoperative adverse reactions(5 vs.15) in group N were significantly lower than those in group C (P<0.05).Conclusion Prophylactic analgesia with continuous lumbar plexus nerve block immediately after admission can effectively shorten the length of hospital stay, reduce the degree of pain, reduce the incidence of complications, and promoteearly and rapid recovery of elderly patients with femoral neck fracture. |
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