摘要
目的探究超声引导下高位髂筋膜阻滞对髋关节置换术患者术后疼痛程度的影响。方法选取2022年3月-2023年8月我院收治的髋关节置换术患者72例,按照随机数字法将其分为对照组和观察组,每组各36例,并实施不同麻醉阻滞方式。对照组实施全身麻醉,观察组全身麻醉联合超声引导下高位髂筋膜阻滞。对比两组患者术后不同时点疼痛程度、血流动力学指标以及凝血功能。结果观察组术后6、24、48 h疼痛程度评分低于对照组(P<0.05);术前两组患者平均动脉压(MAP)、呼吸(HR)水平对比,差异不具有显著性意义(P>0.05);手术开始1、24 h,患者MAP、HR逐渐下降,观察组高于对照组,组间差异具有显著性意义(P<0.05)。术前两组血栓弹力图反应时间(R)、凝集块形成速率(α)、最大振幅(MA)以及凝血综合指数(CI)对比,差异不具有显著性意义(P>0.05);术后24 h,患者R值提升,MA、α、CI值下降,观察组优于对照组,组间差异具有显著性意义(P<0.05)。结论超声引导下高位髂筋膜阻滞对髋关节置换术患者术后疼痛程度有显著影响,可以降低疼痛程度,抑制炎症反应,缩短血栓弹力图反应时间,并改善患者术后高凝状态。
Objective:To explore the effect of ultrasound-guided high iliac fascia block on postoperative pain in patients with hip replacement.Methods:A total of 72 patients who received hip replacement admitted to our hospital from March 2022 to August 2023 were selected,and were randomly divided into the control group and the observation group,with different anesthetic block methods with 36 cases in each group.The control group received general anesthesia and the observation group received general anesthesia combined with ultrasound-guided high iliac fascial block.The postoperative pain degree,hemodynamic indicators,and coagulation function at different time points after surgery were compared between the two groups.Results:The pain score of the observation group was lower than that of the control group at 6,24 and 48 h postoperatively(P<0.05);There was no significant difference in mean arterial pressure(MAP)and respiration(HR)between the two groups before surgery(P>0.05).The MAP and HR of patients gradually decreased from 1 h after surgery to 24 h after surgery,which were higher in the observation group than those in the control group,with significant differences(P<0.05);Before surgery,there was no significant difference in thromboelastogram reaction time(R),clot formation rate(α),maximum amplitude(MA)and coagulation composite index(CI)between the two groups(P>0.05).At 24 h after surgery,R value of patients increased while MA,αand CI values decreased.The observation group was superior to the control group,with significant differences(P<0.05).Conclusion:Ultrasound-guided high iliac fascia block significantly reduces postoperative pain degree,and inflammatory reaction in patients with hip replacement,while shortening thromboelastogram response time and alleviating postoperative hypercoagulability.
作者
钟红辉
ZHONG Hong-hui(Yudu County People's Hospital,Yudu Jiangxi 342300,China)
出处
《透析与人工器官》
2025年第1期6-9,65,共5页
Chinese Journal of Dialysis and Artificial Organs
