神经刺激器定位下行腰丛复合坐骨神经阻滞对老年髋关节置换术患者免疫功能的影响

目的 探究神经刺激器定位下行腰丛复合坐骨神经阻滞对老年髋关节置换术患者术后免疫功能的影响.方法 前瞻性收集本院2016年2月至2018年10月收治的86例接受髋关节置换术治疗的老年患者为研究对象,依据随机数字表的方式分组,每组43例.其中,对照组进行硬膜外麻醉,观察组进行神经刺激器定位下腰丛复合坐骨神经阻滞麻醉.观察对...

Effect of neurostimulator positioning of lumbar plexus combined with sciatic nerve block on immune function in elderly patients undergoing hip replacement

Objective To explore the effect of neurostimulator positioning on the postoperative immune function of elderly patients undergoing hip replacement with lumbar plexus combined with sciatic nerve block.Methods Eighty-six elderly patients who underwent hip arthroplasty from February 2016 to October 2018 were enrolled in the study.They were grouped according to a random number table,with 43 patients in each group.Among them,the control group underwent epidural anesthesia,and the observation group underwent neurostimulator positioning under the lumbar plexus combined with sciatic nerve block anesthesia.The T lymphocyte subsets,inflammatory factor levels,sensory nerves,motor block time,infection and other adverse reactions occurred at different time points in the two groups.Results The levels of CD⁺₃,CD⁺₄,CD⁺₄/CD⁺₈in T lymphocyte subsets in the observation group were significantly higher than the control group at the T₁ and T₂ time points(P<0.05).The levels of inflammatory factors IL-6 and TNF-αwere significantly lower than the control group,which was statistically significant(P<0.05).In the observation group,the onset time of sensory nerve block and motor block was significantly faster than the control group(P<0.05);the maintenance time was significantly longer than the control group(P<0.05).And the incidence of adverse reactions such as observation group infection was significantly lower than the control group,which was statistically significant(P<0.05).Conclusions The neurostimulator positioning of the lumbar plexus combined with sciatic nerve block anesthesia is superior to epidural anesthesia in elderly patients undergoing hip replacement surgery,which is beneficial to maintain the level of T lymphocyte subsets,reduce the immune function,and reduce the inflammatory response.And the occurrence of adverse reactions such as infection is an ideal anesthesia method for elderly hip replacement.