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超声引导下FICB对THA术后患者疼痛及预后的影响分析
作者:邹振宇  武长君  宋仕钦  任江 
单位:攀枝花市第二人民医院 麻醉科, 四川攀枝花 617068
关键词:超声引导 髂筋膜间隙阻滞 全髋关节置换术 疼痛 应激 预后 
分类号:R614
出版年·卷·期(页码):2020·48·第十期(1294-1297)
摘要:

目的:探讨超声引导下髂筋膜间隙阻滞(FICB)部位的精准选择对全髋关节置换术(total hip arthroplasty,THA)后患者血清疼痛相关指标、应激指标及预后的影响分析。方法:选取我科收治的92例行THA的患者,根据术后行FICB部位的不同,分为研究组及对照组,各46例,其中研究组(采用腹股沟韧带上FICB镇痛治疗)和对照组(采用腹股沟韧带下FICB镇痛治疗),比较两组患者的临床疗效等差异。结果:术后72 h内研究组自控镇痛次数、舒芬太尼消耗量及不良反应发生率均显著低于对照组(P<0.05);研究组闭孔神经及股外侧皮神经的感觉阻滞成功率高于对照组,血清疼痛相关指标和应激指标均较对照组改善明显,生活质量评分高于对照组(均P<0.05)。结论:经腹股沟韧带上行FICB镇痛治疗效果优于腹股沟韧带下FICB,同时可减轻THA患者术后的应激反应程度并提高其生活质量,值得临床推广应用。

Objective: To investigate the impact of ultrasound-guided fascia iliaca compartment block(FICB) site selection on serum pain-related indicators, stress indicators and prognosis of patients after total hiparthroplasty(THA).Methods: A total of 92 patients who undergo THAwere selected. According to the location of FICB after operation, they were divided into the study group and the control group,46 cases in each. The study group received FICB analgesia above the inguinal ligament and the control group received FICB analgesia under the inguinal ligament.The clinical efficacy differences between the two groups were compared.Results: The number of patient-controlled analgesia, sufentanil consumption and the incidence of adverse reactions in the study group within 72 hours after surgery were significantly lower than those in the control group(P<0.05); The success rates of sensory block on obturator nerve and lateral femoral cutaneous nerve in the study group were significantly higher than those in the control group, serum pain-related indicators andstress indicatorsin the study group were better than those in the control group, the scores of quality of life in the study group were higher than those in the control group(all P<0.05).Conclusion: The effects of FICB analgesia above the inguinal ligament are better than FICB under the inguinal ligament. It can reduce the postoperative stress response and improve the quality of life of THA patients, which is worthy of clinical application.

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