摘要
目的探讨超声引导下髋关节囊周围神经阻滞对老年髋关节置换术患者疼痛介质与炎症应激反应的影响。方法将2020年2月至2022年3月在该院进行髋关节置换术的180例老年患者按照随机数字表法分为对照组和观察组,每组90例。对照组进行超声引导下髂筋膜间隙阻滞,观察组则进行超声引导下髋关节囊周围神经阻滞。比较两组麻醉前后静息及活动状态下的疼痛视觉模拟评分法(VAS)评分、疼痛介质[神经肽Y(NPY)、P物质(SP)、前列腺素E2(PGE2)]及炎症应激反应指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]水平。结果麻醉前两组静息及活动状态下的VAS评分、NPY、SP、PGE2及CRP、TNF-α、IL-6、IL-10水平比较,差异均无统计学意义(P>0.05);麻醉后15 min、30 min、6 h、12 h及24 h观察组静息及活动状态的VAS评分显著低于对照组,麻醉后1、3 d观察组的NPY、SP、PGE2及CRP、TNF-α、IL-6、IL-10水平均明显低于对照组,差异均有统计学意义(P<0.05)。结论超声引导下髋关节囊周围神经阻滞可有效控制老年髋关节置换术患者疼痛介质与炎症应激反应指标水平,在老年髋关节置换术患者中的应用价值较高。
Objective To investigate the influence of ultrasound-guided hip joint capsule peripheral nerve block on the pain mediators and inflammatory stress response in elderly patients with hip replacement.Methods A total of 180 elderly patients with hip replacement in this hospital from February 2020 to March 2022 were divided into the control group and observation group according to the random number table method,90 cases in each group.The control group conducted fascia iliaca space block guided by ultrasound,while the observation group conducted the hip joint capsule peripheral nerve block guided by ultrasound.The visual analogue scale(VAS)scores of resting and active state and the levels of pain mediators[neuropeptide Y(NPY),substance P(SP),prostaglandin E2(PGE2)]and inflammatory stress response indexes[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)]before and after anesthesia were compared between the two groups.Results There were no statistically significant differences in the VAS scores,NPY,SP,PGE2,CRP,TNF-α,IL-6 and IL-10 levels before anesthesia between the two groups(P>0.05).The resting and active VAS scores at 15,30 min and 6,12,24 h after anesthesia in the observation group were significantly lower than those in the control group,while the levels of NPY,SP,PGE2,CRP,TNF-α,IL-6 and IL-10 on 1,3 d after anesthesia in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The hip joint capsule peripheral nerve block guided by ultrasound could effectively control the pain mediators and levels of inflammatory stress response indicators in elderly patients with hip replacement,so its application value in the elderly patients with hip replacement is relatively higher.
作者
张旭
李龙
张荣建
ZHANG Xu;LI Long;ZHANG Rongjian(Department of Anesthesiology,Ankang Municipal Central Hospital,Ankang,Shaanxi 725000,China)
出处
《检验医学与临床》
CAS
2023年第18期2711-2714,共4页
Laboratory Medicine and Clinic
关键词
超声引导
髋关节囊周围神经阻滞
老年
髋关节置换术
疼痛介质
炎症应激反应
ultrasonic guidance
hip joint capsule peripheral nerve block
elderly
hip replacement
pain mediators
inflammatory stress response
