检验医学与临床2025，Vol.22Issue(8)：1090-1095,6.DOI:10.3969/j.issn.1672-9455.2025.08.016
超声引导下持续髋关节囊周围神经阻滞对老年髋部骨折患者术前镇痛及术后神经认知功能的影响
Effect of continuous pericapsular nerve block of hip joint guided by ultrasound on preoperative analgesia and postoperative neurocognitive function in elderly patients with hip fracture
摘要
Abstract
Objective To investigate the effect of continuous pericapsular nerve block of hip joint guided by ultrasound on preoperative analgesia and postoperative neurocognitive function in elderly patients with hip fracture.Methods A total of 120 elderly patients with hip fracture who were treated in the hospital from May 2021 to May 2023 were selected as subjects and divided into routine group and observation group according to random number table method,with 60 cases in each group.A total of 120 elderly patients with hip fracture who were treated in this hospital from May 2021 to May 2023 were selected as research objects and divided in-to routine group and observation group according to random number table method,with 60 cases in each group.Numeric Rating Scale(NRS)score,and Pittsburgh Sleep Quality Index(PSQI),modified SPIEGEL sleep scale(SPIEGEL)and Depression Anxiety Stress Scale-21(DASS-21)scores were used to evaluate the patients before intervention and after block(tramadol sustained-release tablets in routine group at the same time)at rest and during activity.The waiting time for surgery and intraoperative consumption of remifentanil were recorded.The levels of serum S100β protein,adrenocorticotropic hormone(ACTH),and tumor necrosis factor-α(TNF-α)in the two groups were detected before intervention and 30 min after operation,and the heart rate(HR)of the two groups was recorded.Loewenstein-cognitive assessment(LOTCA)and Montreal Cognitive Assessment(MoCA)were used to evaluate the two groups before intervention and 48 h after opera-tion.The adverse reactions of the two groups were recorded.Results After block,the NRS scores of resting state and activity in the two groups were lower than those before intervention,and those in the observation group were lower than those in the routine group(P<0.05).The PSQI and DASS-21 scores of the two groups after block were lower than those before intervention,and the scores of the observation group were lower than those of the routine group(P<0.05).SPIEGEL scores of the two groups after block were higher than those before intervention,and SPIEGEL scores of the observation group were higher than those of the conventional group(P<0.05).The waiting time for surgery in the observation group was shorter than that in the routine group,and the intraoperative consumption of remifentanil was less than that in the routine group(P<0.05).The levels of serum S100β protein,ACTH,TNF-α and HR 30 min after operation in the two groups were higher than those before intervention(P<0.05).The levels of serum S100β protein,ACTH,TNF-α and HR in the observation group were lower than those in the routine group 30 min after operation(P<0.05).The LOTCA and MoCA scores of the two groups 48 h after operation were lower than those be-fore intervention(P<0.05).The LOTCA and MoCA scores of the observation group were higher than those of the conventional group 48 h after operation(P<0.05).There was no significant difference in the total inci-dence of adverse reactions between the two groups(P>0.05).Conclusion Continuous ultrasound-guided pe-ripheral hip capsule nerve block can improve preoperative analgesia,improve sleep quality,relieve anxiety,re-duce surgical waiting time and remifentanil dosage,reduce S100β protein,ACTH,TNF-α levels and HR,and reduce neurocognitive damage in elderly patients with hip fracture.关键词
超声引导/老年髋部骨折/睡眠质量/焦虑情绪/神经认知功能Key words
ultrasonic guidance/hip fracture in the elderly/sleep quality/anxiety/neurocognitive function分类
临床医学引用本文复制引用
林贤贵,陈诚,何霞..超声引导下持续髋关节囊周围神经阻滞对老年髋部骨折患者术前镇痛及术后神经认知功能的影响[J].检验医学与临床,2025,22(8):1090-1095,6.基金项目
重庆市大足区科技发展项目(DZKJ2022JSYJ-KWXM1027). （DZKJ2022JSYJ-KWXM1027）
