局解手术学杂志2026，Vol.35Issue(4)：350-354,5.DOI:10.11659/jjssx.08E025095
肺保护性通气结合全麻复合股神经、股外侧皮神经阻滞在老年全膝关节置换术中的应用
Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty
摘要
Abstract
Objective To investigate the application effect of lung-protective ventilation combined with general anesthesia and femoral nerve block(FNB)and lateral femoral cutaneous nerve block(LFCNB)in elderly patients undergoing total knee arthroplasty(TKA).Methods A retrospective study was conducted on 82 elderly patients undergoing TKA admitted to the 964th Hospital from September 2022 to July 2024.The patients were divided into the observation group and the control group according to different intervention protocols,with 41 cases in each group.Patients in both groups received general anesthesia combined with FNB and LFCNB.The control group received conventional ventilation management,while the observation group received lung-protective ventilation management.The treatment parameters,hemodynamic parameters[mean arterial pressure(MAP),heart rate(HR)]before anesthesia(T0),5 minutes after induction(T1),at the start of surgery(T2),and at the end of surgery(T3),respiratory oxygenation function[oxygenation index(OI),peak airway pressure(Ppeak),plateau airway pressure(Pplat),positive end-expiratory pressure(PEEP),and static lung compliance]before ventilation and immediately after ventilation,and the incidence of postoperative pulmonary complications were compared between the two groups of patients.Results There was no statistically significant difference in surgical time,intraoperative blood loss,infusion volume,or sufentanil dosage between the two groups of patients(P>0.05).The MAP and HR at T1 and T2 in both groups were lower than those at T0(P<0.05),and the decreases of MAP and HR in the observation group were smaller than those in the control group(P<0.05).After ventilation,the OI,PEEP,and static lung compliance in both groups were lower than those before ventilation(P<0.05),while the Ppeak and Pplat were higher than those before ventilation(P<0.05).The decreases of OI,PEEP,and static lung compliance and the increases of Ppeak and Pplat after ventilation in the observation group were all smaller than those in the control group(P<0.05).The total incidence of postoperative pulmonary complications in the observation group was lower than that in the control group(P<0.05).Conclusion The application of lung-protective ventilation combined with general anesthesia and FNB and LFCNB in elderly patients undergoing TKA can improve respiratory oxygenation function,maintain intraoperative hemodynamic stability,and reduce the risk of postoperative pulmonary complications,with remarkable clinical efficacy.关键词
全膝关节置换术/老年/肺保护性通气/全麻/股神经阻滞/股外侧皮神经阻滞Key words
total knee arthroplasty/elderly/lung-protective ventilation/general anesthesia/femoral nerve block/lateral femoral cutaneous nerve block分类
医药卫生引用本文复制引用
罗莹,周慧鹏,宋鑫,刘冲,王薇..肺保护性通气结合全麻复合股神经、股外侧皮神经阻滞在老年全膝关节置换术中的应用[J].局解手术学杂志,2026,35(4):350-354,5.基金项目
国家卫生健康委"十四五"规划全国重点课题(YYWS4066) （YYWS4066）
