[1]王传福.外周神经阻滞在髋关节置换术中的效果及对围术期氧化应激反应的影响[J].医学信息,2020,33(15):100-102.[doi:10.3969/j.issn.1006-1959.2020.15.030]
　WANG Chuan-fu.The Effect of Peripheral Nerve Block in Hip Arthroplasty and Its Influence on Perioperative Oxidative Stress[J].Medical Information,2020,33(15):100-102.[doi:10.3969/j.issn.1006-1959.2020.15.030]
点击复制

外周神经阻滞在髋关节置换术中的效果及对围术期氧化应激反应的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年15期
页码:
100-102
栏目:
临床研究
出版日期:
2020-08-01

文章信息/Info

Title:
The Effect of Peripheral Nerve Block in Hip Arthroplasty and Its Influence on Perioperative Oxidative Stress
文章编号:
1006-1959（2020）15-0100-03
作者:
王传福
佳木斯市中心医院麻醉科，黑龙江 佳木斯 154002
Author(s):
WANG Chuan-fu
Department of Anesthesiology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,Chin
关键词:
髋关节置换术; 外周神经阻滞; 氧化应激反应
Keywords:
Hip replacement surgery; Peripheral nerve block; Oxidative stress response
分类号:
R614.4
DOI:
10.3969/j.issn.1006-1959.2020.15.030
文献标志码:
A
摘要:
目的 探讨外周神经阻滞在髋关节置换术中的效果及对围术期氧化应激反应的影响。方法 选取2018年1月~2019年6月我院收治的髋关节置换术患者85例，按照随机数表法分为对照组42例和观察组43例。对照组采用全身麻醉，观察组采用外周神经阻滞，比较两组一般情况（麻醉起效时间、舒芬太尼用量、PACU停留时间、术后住院时间）、围术期氧化应激指标[C反应蛋白（CRP）、皮质醇（COR）、去甲肾上腺素（NE）水平]及术后并发症发生情况。结果 两组PACU停留时间、术后住院时间比较[（38.76±19.31）min vs（40.15±20.27）min]、[（12.86±3.34）d vs（13.42±3.67）d]，差异无统计学意义（P＞0.05）；观察组麻醉起效时间、舒芬太尼用量少于对照组[（5.64±2.88）min vs（9.49±3.52）min]、[（12.05±4.53）μg vs（32.38±6.79）μg]，差异有统计学意义（P＜0.05）。观察组手术30 min、手术结束时、术后24 h CRP、COR低于对照组，差异有统计学意义（P＜0.05）；观察组手术30 min、手术结束时NE高于对照组，术后24 h NE水平低于对照组，差异有统计学意义（P＜0.05）；观察组术后并发症发生率为20.93%，低于对照组的42.86%，差异有统计学意义（P＜0.05）。结论 外周神经阻滞用于髋关节置换术中能够减少舒芬太尼用量，缩短麻醉起效时间，减小氧化应激反应，降低术后并发症。
Abstract:
Objective To investigate the effect of peripheral nerve block in hip arthroplasty and its influence on perioperative oxidative stress. Methods A total of 85 hip replacement patients admitted to our hospital from January 2018 to June 2019 were selected and divided into a control group of 42 cases and an observation group of 43 cases according to the random number table method. The control group was given general anesthesia, and the observation group was given peripheral nerve block. The two groups were compared with general conditions (anesthesia onset time, sufentanil dosage, PACU stay time, postoperative hospital stay), perioperative oxidative stress indicators [C Reactive protein (CRP), cortisol (COR), norepinephrine (NE) levels] and postoperative complications.Results Comparison of PACU stay time and postoperative hospital stay [(38.76±19.31) min vs (40.15±20.27) min], [(12.86±3.34)d vs (13.42±3.67)d], the difference was not statistically significant (P＞0.05); The onset time of anesthesia and the dosage of sufentanil in the observation group were less than those in the control group [(5.64±2.88) min vs (9.49±3.52) min], [(12.05±4.53) μg vs (32.38±6.79) μg], the difference was statistically significant (P<0.05). The CRP and COR of the observation group were lower than those of the control group at 30 min after the operation, at the end of the operation, and at 24 h after the operation,the difference was statistically significant (P<0.05); The NE level of the observation group was higher than that of the control group at 30 min after the operation and the end of the operation, and the NE level at 24 h after the operation was lower than that of the control group,the difference was statistically significant (P＜0.05); the postoperative complication rate of the observation group was 20.93%, which was low compared with 42.86% of the control group, the difference was statistically significant (P<0.05).Conclusion Peripheral nerve block used in hip replacement surgery can reduce the amount of sufentanil, shorten the onset time of anesthesia, reduce oxidative stress, and reduce postoperative complications.

参考文献/References:

[1]吴斌,林明侠,沈宁江,等.全髋关节置换术和双极半髋关节置换术治疗老年股骨颈骨折的疗效比较[J].中国老年学杂志,2019,39(5):1099-1101. [2]詹世安,丁晟,宋国全.全髋与半髋关节置换术治疗老年股骨颈骨折的疗效研究[J].临床和实验医学杂志,2016,15(5):475-477. [3]鲁义,姚嘉茵,龚楚链,等.老年髋关节置换术患者术后慢性疼痛的相关因素及其预测模型[J].临床麻醉学杂志,2019,35(12):1197-1200. [4]吴茜,陈明兵,万里,等.不同麻醉方式对髋关节置换术患者早期预后影响的比较[J].中华麻醉学杂志,2018,38(8):899-903. [5]左东,周民.超声引导下腰丛联合骶旁坐骨神经阻滞在高龄股骨颈骨折内固定术中的应用[J].创伤外科杂志,2017,19(7):503-507.[6]马滕,杨涛,薄禄龙,等.全身麻醉与区域麻醉技术对部分手术患者预后影响的研究进展[J].国际麻醉学与复苏杂志,2018,39(5):491-495.[7]董建军,姚型柱,吴超贤.B超引导下骶丛神经阻滞对髋关节置换术患者应激及免疫功能的影响[J].重庆医学,2019,48(12):2061-2066. [8]陆小龙,梅斌,陈士寿,等.超声引导下腰骶丛神经阻滞联合全麻在高龄患者髋关节置换术的临床应用[J].临床麻醉学杂志,2016,32(3):237-240. [9]焦相学,丛仔红,张力强.超声引导下肢神经阻滞用于老年髋关节置换术的镇痛、抗炎、抗氧化效果研究[J].海南医学院学报,2018,24(20):1852-1855. [10]张瑜,王建林.不同麻醉方式对老年髋关节置换术患者麻醉效果、镇痛及术后认知功能的影响[J].中国老年学杂志,2018,38(1):167-169. [11]罗声臻,潘永英,盛福庭,等.超声引导髂筋膜腔隙与髂腹下/髂腹股沟神经复合阻滞在老年患者髋关节置换术术后镇痛中的作用[J].国际麻醉学与复苏杂志,2017,38(6):506-514.[12]王辉,张涤非,金玉坤,等.右美托咪定联合椎管内麻醉对老年髋关节置换术围手术期脑损伤、应激激素及T淋巴细胞亚群的影响[J].海南医学院学报,2018,24(17):1582-1586. [13]张春丽,徐志新.单侧腰部麻醉和全身麻醉对老年患者髋关节置换术应激反应的影响[J].山东医药,2017,57(33):98-100. [14]邹高锐,范钧钊,封享兰,等.七氟醚吸入麻醉联合腰骶丛神经阻滞用于老年患者髋关节置换术的优势评估[J].中华麻醉学杂志,2017,37(10):1180-1183.

相似文献/References:

[1]袁 圆,谢欣颖.气压治疗预防人工髋关节置换术后深静脉血栓的Meta分析[J].医学信息,2019,32(02):107.[doi:10.3969/j.issn.1006-1959.2019.02.030]
　YUAN Yuan,XIE Xin-ying.Meta Analysis on Efficacy of Air Pressure Therapy in Preventing Deep Venous Thrombosis for Lower Limb after Artificial Hip Replacement[J].Medical Information,2019,32(15):107.[doi:10.3969/j.issn.1006-1959.2019.02.030]
[2]史 娜.循证护理在预防人工髋关节置换术后合并深静脉血栓的应用[J].医学信息,2019,32(08):188.[doi:10.3969/j.issn.1006-1959.2019.08.061]
　SHI Na.Application of Evidence-based Nursing in Preventing Deep Venous Thrombosis after Artificial Hip Joint Replacement[J].Medical Information,2019,32(15):188.[doi:10.3969/j.issn.1006-1959.2019.08.061]
[3]田忠丽.基于快速康复外科理念的围手术期护理在髋关节置换术中的应用[J].医学信息,2020,33(18):180.[doi:10.3969/j.issn.1006-1959.2020.18.061]
　TIAN Zhong-li.Application of Perioperative Nursing in Hip Replacement Surgery Based on the Concept of Rapid Rehabilitation Surgery[J].Medical Information,2020,33(15):180.[doi:10.3969/j.issn.1006-1959.2020.18.061]
[4]崔亚楠,于松杨.髂筋膜间隙复合阻滞在下肢手术围术期镇痛中的应用研究[J].医学信息,2020,33(21):46.[doi:10.3969/j.issn.1006-1959.2020.21.014]
　CUI Ya-nan,YU Song-yang.Application of Compound Block of Iliac Fascia Space in Perioperative Analgesia of Lower Limb Surgery[J].Medical Information,2020,33(15):46.[doi:10.3969/j.issn.1006-1959.2020.21.014]
[5]肖凯敏,谢 懿,曾会龙,等.X线、CT及MRI在行髋关节置换治疗术后并发症诊断中的价值分析[J].医学信息,2023,36(13):99.[doi:10.3969/j.issn.1006-1959.2023.13.019]
　XIAO Kai-min,XIE Yi,ZENG Hui-long,et al.Value Analysis of X-ray, CT and MRI in the Diagnosis of Complications After Hip Replacement[J].Medical Information,2023,36(15):99.[doi:10.3969/j.issn.1006-1959.2023.13.019]
[6]刘广宁.不同体位护理频次在老年髋关节置换术患者中的应用效果[J].医学信息,2024,37(01):175.[doi:10.3969/j.issn.1006-1959.2024.01.032]
　LIU Guang-ning.Application Effect of Different Position Nursing Frequency in Elderly Patients with Hip Replacement[J].Medical Information,2024,37(15):175.[doi:10.3969/j.issn.1006-1959.2024.01.032]

更新日期/Last Update: 1900-01-01