| 张亚君,王 晖,常建华,郝亚波,赵永斌.超声引导下神经阻滞麻醉联合全身麻醉对股骨头置换老年患者麻醉效果及术后认知功能的影响[J].,2023,(5):904-908 |
| 超声引导下神经阻滞麻醉联合全身麻醉对股骨头置换老年患者麻醉效果及术后认知功能的影响 |
| Effects of Ultrasound-guided Nerve Block Anesthesia on Anesthetic Effect and Postoperative Cognitive Function in Senile Patients Undergoing Femoral Head Replacement |
| 投稿时间：2022-04-26 修订日期：2022-05-22 |
| DOI：10.13241/j.cnki.pmb.2023.05.020 |
| 中文关键词: 超声引导神经阻滞麻醉 术后认知功能 股骨头置换 老年患者 |
| 英文关键词: Ultrasound-guided nerve block anesthesia Postoperative cognitive dysfunction Femoral head replacement Senile patient |
| 基金项目:陕西省重点研发计划基金项目（2019SF-049） |
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| 中文摘要: |
| 摘要 目的：研究超声引导神经阻滞麻醉联合全身麻醉对股骨头置换老年患者的麻醉效果及对术后认知功能的影响。方法：选取2019年1月至2021年12月期间我院收治的150例拟行股骨头置换术的老年患者，随机分为对照组和观察组，各75例。对照组患者行常规全身麻醉，观察组在对照组的基础上行超声引导下神经阻滞麻醉，比较两组患者的血流动力学指标，拔管时间、苏醒时间和复苏室停留时间，苏醒后疼痛，术后认知功能及不良反应的发生率。结果：观察组患者各时间点的心率（HR）和平均动脉压（MAP）均较对照组低（P＜0.05）。观察组拔管时间、苏醒时间和复苏室停留时间均较对照组短（P＜0.05）。观察组患者术后视觉模拟评分（VAS）均低于同一时间点的对照组（P＜0.05）。与对照组相比，观察组患者术后1 h、12 h和24 h的简易智力状态检查（MMSE）评分均较高（P＜0.05），观察组术后1 h、12 h和24 h术后认知功能障碍（POCD）发生率较对照组低（P＜0.05）。两组患者不良反应发生率无差异（P＞0.05）。结论：超声引导神经阻滞麻醉可稳定血流动力学，缩短拔管、苏醒及复苏室停留时间，减轻术后疼痛，改善术后认知功能，减少POCD的发生，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of ultrasound-guided nerve block anesthesia on anesthetic effect and postoperative cognitive function in senile patients undergoing femoral head replacement. Methods: 150 senile patients scheduled for lfemoral head replacement admitted to our hospital from January 2019 to December 2021 were randomly divived into control group and observation group, each group has 75 patients. The control group received general anesthesia, the observation group received ultrasound-guided nerve block anesthesia combined with general anesthesia. The hemodynamics indexes, extubation, recovery and PACU stay time, VAS scores, postoperative cognitive function and adverse reactions of two groups were compared. Results: The heart rate(HR) and mean arterial pressure(MAP) of observation group were lower than control group at each time point (P<0.05). The extubation, recovery and PACU stay time of observation group were shorter as compared with control group (P<0.05). The VAS scores of observation group were lower than control group at each time point postoperative (P<0.05). Comparing with control group, the mini-mental state examination(MMSE) scores of observation group at 1 h, 12 h and 24 h postoperative were higher, the incidence of postoperative cognitive dysfunction (POCD) of observation group at 1 h, 12 h and 24 h postoperative were lower than control group (P<0.05). There were no significant differences of adverse reactions of two groups(P＞0.05). Conclusion: Ultrasound-guided nerve block anesthesia could stabilize hemodynamic, shorten extubation, recovery and PACU stay time, relieve postoperative pain, improve postoperative cognitive function, which deserves the clinical expansion. |
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