髂筋膜间隙阻滞联合全身麻醉对髋关节置换术后疼痛及炎症应激介质分泌的影响被引量：37

Effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement

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摘要目的:探讨髂筋膜间隙阻滞联合全身麻醉对髋关节置换术后疼痛及炎症应激介质分泌的影响。方法:选取在本院接受髋关节置换的股骨颈骨折患者170例,回顾麻醉方案并将其分为接受常规全身麻醉的对照组103例、接受髂筋膜间隙阻滞联合全身麻醉的研究组67例。对比两组患者手术结束即刻、术后12h、术后24h血清中疼痛介质、炎症因子、应激激素含量的差异。结果:手术结束即刻,两组血清中疼痛介质、炎症因子、应激激素含量的差异无统计学意义。术后12h、术后24h,研究组患者血清中疼痛介质NPY、PGE2、5-HT、β-EP、SP的含量低于对照组患者;血清中炎症因子CRP、TNF-α、IL-1β的含量低于对照组患者;血清中应激激素Cor、CA、ACTH的含量低于对照组患者。结论:髋关节置换术患者接受髂筋膜间隙阻滞联合全身麻醉,可有效减轻术后疼痛以及由疼痛激发的全身炎症、应激反应。 Objective：To investigate the effect of fascia iliaca compartment block combined with general anesthesia on the pain and inflammatory stress mediator secretion after hip replacement.Methods：A total of 170 patients with femoral neck fracture who underwent hip replacement in this hospital between September 2015 and August 2017 were divided into the control group（n=103）who underwent routine general anesthesia and the study group（n=67）who underwent fascia iliaca compartment block combined with general anesthesia after the anesthetic solutions were reviewed.The differences in serum contents of pain mediators,inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery as well as 12 hand 24 hafter surgery.Results：Immediately after surgery,there was no statistically significant difference in serum contents of pain mediators,inflammatory factors and stress hormones between the two groups.12 hand 24 hafter surgery,serum pain mediators NPY,PGE2,5-HT,β-EP and SP contents of study group were lower than those of control group;serum inflammatory factors CRP,TNF-αand IL-1βcontents were lower than those of control group;serum stress hormones Cor,CA and ACTH contents were lower than those of control group.Conclusion：fascia iliaca compartment block combined with general anesthesia can effectively reduce the postoperative pain as well as the systemic inflammatory response and stress response induced by pain in patients with hip replacement.

作者黄晓萍喻耀华 HUANG Xiao-Ping;YU Yao-Hua(Department of Anesthesiology,the First Hospital of Putian City Fujian Province,351100, China)

机构地区福建省莆田市第一医院麻醉科

出处《海南医学院学报》 CAS 2018年第5期604-607,共4页 Journal of Hainan Medical University

基金福建省卫生厅青年科研课题资助计划(2014-2-79)~~

关键词髋关节置换术髂筋膜间隙阻滞疼痛炎症反应应激反应 Hip replacement Fascia iliaca compartment block Pain Inflammatory response Stress response

分类号 R274.1 [医药卫生—中医骨伤科学]