B超引导下隐神经阻滞与股神经阻滞在大隐静脉高位结扎剥脱的日间手术中的应用效果比较

Comparison of the Effect of B-Ultrasound Guided Saphenous Nerve Block and Femoral Nerve Block in Day Surgery of High Saphenous Vein Ligation and Stripping

摘要: 目的：探讨在大隐静脉高位结扎剥脱的日间手术中应用B超引导下隐神经阻滞与股神经阻滞的效果。方法：本文收集2018年8月~2020年8月就诊于本院的92例行大隐静脉高位结扎剥脱日间手术患者作为研究对象，采用随机方式分组为研究组(n = 46)与对照组(n = 46)。研究组采用B超引导下隐神经阻滞，对照组采用B超引导下股神经阻滞。比较两组的阻滞成功率、血流动力学及VAS评分、下肢肌力评分。结果：两组术前、术中、术后的血压、心率比较均无统计学意义(P > 0.05)。两组的阻滞成功率比较无统计学意义(P > 0.05)。研究组术后4 h、术后8 h的下肢肌力评分明显高于对照组，差异有统计学意义(P < 0.05)。研究组术后4 h、术后8 h的VAS评分均明显低于对照组，差异有统计学意义(P < 0.05)。结论：在大隐静脉高位结扎剥脱的日间手术中应用B超引导下隐神经阻滞与股神经阻滞的阻滞效果均较好，但行B超引导下隐神经阻滞的镇痛效果更佳，且对患者下肢运动影响更小，具有临床应用价值。

Abstract: Objective: To explore the effect of B-ultrasound guided saphenous nerve block and femoral nerve block in day surgery of high ligation and stripping of great saphenous vein. Methods: In this study, 92 patients who underwent day surgery for high saphenous vein ligation and stripping were collected in our hospital from August 2018 to August 2020 as the research objects, and they were randomly divided into the study group (n = 46) and the control group (n = 46). The study group used ultrasound-guided saphenous nerve block, and the control group used B-ultrasound guided femoral nerve block. The block success rate, hemodynamics, VAS score, and lower limb muscle strength score were compared between the two groups. Results: The comparison of blood pressure and heart rate before, during and after the two groups was not statistically significant (P > 0.05). The block success rate of the two groups was not statistically significant (P > 0.05). The lower limb muscle strength scores of the study group at 4 h and 8 h after surgery were significantly higher than those of the control group, and the difference was statistically significant (P < 0.05). The VAS scores of the study group 4 h and 8 h after operation were significantly lower than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion: In the daytime operation of high saphenous vein ligation and stripping, the effects of B-ultrasound guided saphenous nerve block and femoral nerve block are better, but the analgesic effect of B-ultrasound guided saphenous nerve block is better, has less impact on patients’ lower limb movement, and has clinical application value.