目的 分析腰丛复合坐骨神经阻滞麻醉对老年人股骨颈骨折患者术中血压、心率、不良反应及预后的影响。方法 随机抽取2016年2月—2018年8月期间行股骨颈骨折手术的100例老年人患者作为本次研究对象,分为研究组、对照组,每组各有50例。对照组给予腰硬联合麻醉,研究组给予腰丛复合坐骨神经阻滞麻醉,对两组患者的心率及血压进行分析。结果 对照组与研究组麻醉前后的心率、舒张压、收缩压的变化情况无明显区别,且对照组头痛、恶心、呕吐等不良反应发生率(12.00%)高于研究组(4.00%),但对照组的不良反应发生率与研究组相比较差异无统计学意义(P>0.05);而对照组的术中出血量、术中输血量、骨折愈合时间明显高于研究组,两组差异有统计学意义(P<0.05)。结论 在老年人股骨颈骨折患者术中采用腰丛复合坐骨神经阻滞麻醉可有效诱导患者的血压、心率保持稳定,减少术中输血量,缩短骨折愈合时间,提高患者治疗安全性,值得推广应用。

Objective To analyze the effect of lumbar plexus combined with sciatic nerve block anesthesia on blood pressure, heart rate, adverse reaction, and prognosis in elderly patients with femoral neck fracture.Methods A total of 100 elderly patients who underwent femoral neck fracture surgery in our hospital from February 2016 to August 2018 were randomly selected as the study subjects and divided into study group and control group, with 50 cases in each group.The control group was given combined spinal-epidural anesthesia, and the study group was given combined lumbar plexus and sciatic nerve block anesthesia.The heart rate and blood pressure were compared between the two groups.Results The heart rate, diastolic blood pressure, and systolic blood pressure before and after anesthesia in the control group were not significantly different from those in the study group.The incidence rate of adverse reactions such as headache, nausea, and vomiting in the control group was 12.00%, higher but not statistically than that in the study group (4.00%)(P>0.05).The blood loss volume, blood transfusion volume, and fracture healing time in the control group were significantly higher than those in the study group (P<0.05).Conclusion The application of lumbar plexus combined with sciatic nerve block anesthesia in elderly patients with femoral neck fracture can effectively induce stable blood pressure and heart rate, reduce intraoperative blood transfusion, shorten fracture healing time, and improve the safety of treatment, which is worthy of popularization and application.