| 髂筋膜间隙阻滞对前外侧小切口入路全髋置换术的影响 |
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Received:November 20, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吴海贺 |
WU Hai-he |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
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| 齐岩松 |
QI Yan-song |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
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| 赵智慧 |
ZHAO Zhi-hui |
内蒙古自治区人民医院麻醉科, 内蒙古 呼和浩特 010017 |
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| 包呼日查 |
BAOHU Ri-cha |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
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| 吕飞 |
LYU Fei |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
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| 王一帆 |
WANG Yi-fan |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
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| 徐永胜 |
XU Yong-sheng |
内蒙古自治区人民医院骨关节科, 内蒙古 呼和浩特 010017 |
Department of Orthopaedics, Inner Mongolia People's Hospital, Hohhot 010017, Inner Mongolia, China |
dlxyf@163.com |
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| 期刊信息：《中国骨伤》2022年35卷，第7期，第620-625页 |
| DOI：10.12200/j.issn.1003-0034.2022.07.005 |
| 基金项目:国家自然科学基金地区科学基金项目（编号：81560374）；国家自然科学基金地区科学基金项目（编号：81960399）；内蒙古自治区科技计划项目（编号：201802154） |
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目的:比较单纯椎管内麻醉与联合髂筋膜间隙阻滞（fascia iliaca compartment block，FICB）对前外侧小切口（orthopädische chirurgie München，OCM）入路全髋关节置换术（total hip arthroplasty，THA）的影响分析。
方法：2019年1月至2020年10月择期行单侧全髋关节置换术患者，分别采用椎管内麻醉复合超声引导下髂筋膜间隙阻滞（A组30例）和单纯椎管内麻醉（B组30例）。两组患者椎管内用药成分相同，术后采用相同静脉镇痛治疗方案。观察比较两组手术时间、术中出血量、臀中肌剥离程度、股骨大转子劈裂情况，术后髋关节疼痛视觉模拟评分（visual analogue scale，VAS），术前及术后48 h 股四头肌及髋关节外展肌力，术后髋关节功能Harris评分。
结果：所有患者获得随访，时间48~62（54.2±4.0）周。A组患者切口长度、手术时间及术中出血量明显低于B组（P<0.05）。A组术后24 h血红蛋白水平明显高于B组（P<0.05）。A组术后48 h髋关节外展肌力明显高于B组（P<0.05）。A组患者臀中肌剥离程度明显低于B组（P<0.05）。A组患者术后8、12、24 h VAS明显低于B组（P<0.05）；A组患者术后2、8周Harris评分明显高于B组（P<0.05）。
结论：超声引导下髂筋膜间隙阻滞应用于侧卧位OCM入路THA，能明显缩短手术时间、减少术中出血量、减少术中臀中肌剥离情况等髋关节周围创伤及改善患者术后早期疼痛，有利于OCM入路临床操作及患者术后快速康复。 |
| [关键词]:关节成形术,置换,髋 髂筋膜 神经传导阻滞 |
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| Effect of fascia iliaca compartment block on anterolateral small incision total hip arthroplasty |
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Abstract:
Objective: To compare the effects of simple intraspinal anesthesia and combined fascia iliaca compartment block(FICB) on total hip arthroplasty(THA) through anterior lateral small incision (orthop dische chirurgie München, OCM).
Methods: From January 2019 to October 2020, patients undergoing unilateral total hip arthroplasty were treated with intraspinal anesthesia combined with ultrasound-guided fascia iliaca compartment block(30 cases in group A) and simple intraspinal anesthesia(30 cases in group B). Two groups were treated with the same intravenous analgesia after operation. The operation time, the amount of bleeding, the peeling degree of middle gluteal muscle, the splitting of greater trochanter of femur, the visual analysis scale (VAS) of hip joint after operation, the abductor muscle strength of quadriceps femoris and hip joint before and 48 hours after operation, and the Harris score of hip joint function after operation were observed and compared between two groups.
Results: All patients were followed up for 48 to 62 weeks with an average of (54.2±4.0) weeks. The incision length, operation time and intraoperative bleeding in group A were significantly lower than those in group B (P<0.05). The level of hemoglobin 24 hours after operation in group A was significantly higher than that in group B (P<0.05). The abductor muscle strength of hip joint in group A was significantly higher than that in group B 48 hours after operation (P<0.05). The degree of middle gluteal muscle dissection in group A was significantly lower than that in group B (P<0.05). The VAS of group A at 8, 12 and 24 hours after operation was significantly lower than that of group B (P<0.05);The Harris score in group A was significantly higher than that in group B at 2 and 8 weeks after operation (P<0.05).
Conclusion: The application of ultrasound-guided fascia iliaca compartment block in lateral position OCM approach THA can significantly shorten the operation time, reduce the amount of bleeding, reduce the perihip trauma such as the peeling of middle gluteal muscle during operation, and improve the early postoperative pain of patients, which is conducive to the clinical operation of OCM approach and the rapid postoperative recovery of patients. |
| KEYWORDS:Arthroplasty, replacement, hip Fascia iliaca Nerve block |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴海贺,齐岩松,赵智慧,包呼日查,吕飞,王一帆,徐永胜.髂筋膜间隙阻滞对前外侧小切口入路全髋置换术的影响[J].中国骨伤,2022,35(7):620~625 |
| 英文格式: | WU Hai-he,QI Yan-song,ZHAO Zhi-hui,BAOHU Ri-cha,LYU Fei,WANG Yi-fan,XU Yong-sheng.Effect of fascia iliaca compartment block on anterolateral small incision total hip arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(7):620~625 |
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