Application of femoral nerve block combined with modified swelling anesthesia in high ligation and stripping of great saphenous vein.
Application of femoral nerve block combined with modified swelling anesthesia in high ligation and stripping of great saphenous vein.
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DOI：
10.3389/fsurg.2022.1086735
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发表时间：
2022
影响因子：
1.8
通讯作者：
Lin C
中科院分区：
文献类型：
--
作者：
Chen X;Liu Z;Zhou B;Fan Z;Zhao H;Lin C
分析探讨超声引导下股神经阻滞联合改良肿胀麻醉液在大隐静脉高位结扎剥脱术中的临床疗效。90例下肢大隐静脉曲张行大隐静脉高位结扎剥脱术患者随机分为A组（股神经阻滞联合改良肿胀麻醉）、B组（单纯肿胀麻醉）和C组（硬膜外麻醉），每组30例。比较3组患者的血清CRP水平、手术时间、术中出血量、术后住院时间、住院总费用、术后VAS评分、术前及术后VCSS评分、术中平均动脉压和心率、术后相关并发症、患者对诊疗的满意度。三组患者手术时间、术中出血量、术后并发症、术前术后VCSS评分差异均无统计学意义（P > 0.05）。A、B组患者术后住院时间、术后VAS评分及住院总费用均低于C组，且A组患者术后住院时间及术后VAS评分更明显（P < 0.05）。与B组相比，A组和C组术中平均动脉压、心率波动幅度及术后血清CRP水平均较低，以A组为著（P < 0.05）。术后定期随访3组患者。结果显示，A组术后并发症例数低于其他两组（P < 0.05），三组术后并发症经对症处理（换药、抗感染、服用改善循环药物等）后均得到有效缓解。A组患者满意度明显高于B、C组（P < 0.05）。超声引导下股神经阻滞联合改良肿胀麻醉液应用于大隐静脉高位结扎剥脱术，可显著改善患者术后炎症应激反应，有效保证手术进程的安全可靠，有助于提高镇痛效果，加快身体康复，且住院时间短，医疗费用低，患者诊疗满意度高，值得临床广泛推广和借鉴。
To analyze and explore the clinical efficacy of ultrasound guided femoral nerve block combined with modified swelling anesthetic solution in high ligation and stripping of the great saphenous vein. 90 patients with varicose great saphenous vein of lower limbs undergoing high ligation and stripping of great saphenous vein were randomly divided into group A (femoral nerve block combined with modified swelling anesthesia), group B (simple swelling anesthesia) and group C (epidural anesthesia), with 30 patients in each group. The serum CRP level, operation duration, intraoperative blood loss, postoperative hospitalization time, total hospitalization cost, postoperative VAS score, preoperative and postoperative VCSS score, intraoperative mean arterial pressure and heart rate, postoperative related complications, and patients, satisfaction with diagnosis and treatment were compared among the three groups. There was no significant difference in operation duration, intraoperative blood loss, postoperative complications, and preoperative and postoperative VCSS scores among the three groups (P > 0.05). The postoperative hospitalization time, postoperative VAS score and total hospitalization cost of patients in group A and B were lower than those in group C, and the postoperative hospitalization time and postoperative VAS score in group A were more significant (P < 0.05). Compared with group B, the fluctuation range of intraoperative mean arterial pressure and heart rate, and postoperative serum CRP level in group A and C were lower, especially in group A (P < 0.05). The three groups of patients were followed up regularly after surgery. The results showed that the number of postoperative complications in group A was lower than that in the other two groups (P < 0.05), and the postoperative complications of the three groups were effectively relieved after symptomatic treatment (dressing change, anti-infection, taking drugs to improve circulation, etc.). The satisfaction of patients in group A was significantly higher than that in groups B and C (P < 0.05). Ultrasound guided femoral nerve block combined with modified swelling anesthetic solution applied in high ligation and stripping of the great saphenous vein can significantly improve postoperative inflammatory stress reaction of patients, effectively ensure the safety and reliability of surgical progress, help to improve analgesia effect and accelerate physical rehabilitation, and has short hospitalization time, low medical cost, and high satisfaction of patients' diagnosis and treatment, which is worthy of widespread clinical promotion and reference.
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影响因子：
3.6
作者：
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通讯作者：
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