1例老年股骨颈骨折患者围术期多时机、多模式镇痛方案报告

中华养生保健 ›› 2025, Vol. 43 ›› Issue (5): 13-16.

1例老年股骨颈骨折患者围术期多时机、多模式镇痛方案报告

孙海滨¹, 刘玉银², 刘丽娜¹, 刘继昌³, 梁凯¹, 孙永刚^1,*

1.山东第二医科大学附属中医院麻醉二科,山东潍坊,261041;
2.山东第二医科大学附属中医院肿瘤外科,山东潍坊,261041;
3.山东第二医科大学附属中医院手术室,山东潍坊,261041

出版日期:2025-03-01 发布日期:2025-03-17
通讯作者: ^*孙永刚,E-mail：weifangsyg@163.com。
作者简介:孙海滨（1991—）,男,汉族,籍贯：山东省潍坊市,硕士研究生,主治医师,研究方向：外科学,麻醉舒适化,小儿、老年麻醉。
基金资助:
潍坊市卫生健康委科研项目（WFWSJK-2023-086）

A Report on Multi-time and Multi-mode Analgesia Plan in the Perioperative Period for An Elderly Patient with Femoral Neck Fracture

SUN Hai-bin¹, LIU Yu-yin², LIU Li-na¹, LIU Ji-chang³, LIANG Kai¹, SUN Yong-gang^1,*

1. Anesthesia Department, Affiliated Traditional Chinese Medicine Hospital of Shandong Second Medical University, Weifang Shandong, 261041, China;
2. Oncologic Surgery, Affiliated Traditional Chinese Medicine Hospital of Shandong Second Medical University, Weifang Shandong, 261041, China;
3. Operating Room, Affiliated Traditional Chinese Medicine Hospital of Shandong Second Medical University, Weifang Shandong, 261041, China

Online:2025-03-01 Published:2025-03-17

摘要/Abstract

摘要： 老年髋部骨折常被称为“人生最后一次骨折”,随着人口老龄化问题进一步加剧,髋部骨折发病率已成为严重的社会问题。笔者对2023年7月潍坊市中医院运动医学科收治的1例老年股骨颈骨折患者围术期多时机、多模式镇痛麻醉方案进行汇报。患者为老年女性,76岁,摔伤致左髋部肿痛、活动受限10 d入院。患者当地医院明确诊断后保守治疗10 d,期间疼痛难忍,睡眠及饮食严重受限,治疗效果欠佳,为求进一步治疗收入潍坊市中医院住院治疗。笔者通过对该患者围术期多时机、多模式镇痛麻醉治疗干预,达到了围术期舒适化的目的 ,患者康复出院,患者及家属的满意度高。

关键词: 老年股骨颈骨折, 多模式围术期镇痛, 中医五音疗法, 舒适化医疗, 病例报告

Abstract: Hip fractures in the elderly are often referred to as “the last fracture of life” and with the aging of the population, the incidence of hip fractures has become a serious social problem. Studies have shown that hip fractures affect 18% of women and 6% of men worldwide, with 30% of cases originating from China. This report presents a case of an elderly femoral neck fracture patient treated in the Department of Sports Medicine at Weifang Traditional Chinese Medicine Hospital in July 2023, highlighting the perioperative multi-timing, multi-modal analgesic anesthesia plan. The patient was an elderly female, 76 years old, who was admitted to the hospital with a fall injury resulting in swelling and pain in the left hip and limitation of activities for 10 days. After a clear diagnosis at a local hospital, she received conservative treatment for 10 days. During this period, she suffered from unbearable pain and severe restrictions on sleep and food intake, and the treatment outcome was unsatisfactory, so she was admitted to Weifang Traditional Chinese Medicine Hospital for further treatment. Through the perioperative multi-timing, multi-modal anesthesia intervention for this patient, we achieved the goal of comfortable perioperative care. The patient recovered and was discharged from the hospital, with a high degree of satisfaction from the patient and his family.

Key words: fracture of neck of femur, multimodal perioperative analgesia, five-tone therapy in traditional Chinese medicine, comfort medicine, case report

中图分类号:

R614

孙海滨, 刘玉银, 刘丽娜, 刘继昌, 梁凯, 孙永刚. 1例老年股骨颈骨折患者围术期多时机、多模式镇痛方案报告[J]. 中华养生保健, 2025, 43(5): 13-16.

SUN Hai-bin, LIU Yu-yin, LIU Li-na, LIU Ji-chang, LIANG Kai, SUN Yong-gang. A Report on Multi-time and Multi-mode Analgesia Plan in the Perioperative Period for An Elderly Patient with Femoral Neck Fracture[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(5): 13-16.

参考文献

[1] LAUFENBERG-FELDMANN R, MÜLLER M, FERNER M, et al. Is ‘anxiety sensitivity’ predictive of postoperative nausea and vomiting?: A prospective observational study[J].Eur J Anaesthesiol.,2019,36(5):369-374.
[2] 庄巧梅,吴少萍,吴婷,等.睡眠质量对老年髋关节置换术后谵妄的影响探究[J].世界睡眠医学杂志,2023,10(11):2608-2610.
[3] 梁艳艳,盖海云,曹丹凤,等.老年住院患者睡眠质量现况调查及相关因素分析[J].山西医药杂志,2022,51(1):9-13.
[4] 谢娟,王敏,夏阔,等.超声引导下腹股沟韧带上髂筋膜间隙阻滞在老年髋部骨折患者围术期镇痛中的应用研究[J].老年医学与保健,2024,30(3):846-852.
[5] 潘闰梅,黄继梅,肖虹.中医五音疗法对患者围术期焦虑状态干预效果的临床研究[J].现代医院,2024,24(1):156-158.
[6] 李辉波,苏钰淇,曾志文.术后急性疼痛与睡眠障碍相互影响的研究进展[J].临床麻醉学杂志,2024,40(5):553-556.
[7] 谢小芬,许佳丽,路遥,等.基于循证理论构建治疗焦虑症的情志调理五音曲库[J].循证护理,2024,10(6):1049-1054.
[8] 赵峰,杨光,黄礼兵,等.髂筋膜腔阻滞联合喉罩在老年患者髋部骨折术中的临床应用[J].东南国防医药,2018,20(6):606-609.
[9] BIRNBACH D J, BATEMAN B T.Obstetric Anesthesia: Leading the Way in Patient Safety[J].Obstet Gynecol Clin North Am.,2019,46(2):329-337.
[10] 于布为. 麻醉科建设发展纲要[J].上海医学,2019,42(9):4.
[11] YANG Q, LI J, SHI D, et al.Incidence and risk factors associated with hospital-acquired pressure ulcers following total hip arthroplasty: A retrospective nationwide inpatient sample database study[J].J Tissue Viability,2022,31(2):332-338.
[12] GLARE P, AUBREY K R, MYLES P S.Transition from acute to chronic pain after surgery[J].Lancet,2019,393(10180):1537-1546.
[13] 陶慧,王婷婷,王丽平,等.老年股骨近端骨折术前及术后早期康复干预对骨折愈合时间和心理状态的影响[J].河北医药,2022,51(17):044.
[14] 梁淑娟,刘文超,韩珊珊,等.咪达唑仑对术前中重度焦虑老年患者结直肠癌根治术后谵妄的影响[J].临床麻醉学杂志,2024,40(1):46-50.
[15] 张颖帆. 神经阻滞联合静脉麻醉在髋关节置换术中的临床应用研究[D].长沙:中南大学,2022.
[16] PEHORA C, PEARSON A M, KAUSHAL A, et al. Dexamethasone as an adjuvant to peripheral nerve block[J].Cochrane Database Syst Rev,2017,11(11):CD011770.
[17] SIVAKUMAR R K, PANNEERSELVAM S, CHERIAN A, et al.Perineural vs. intravenous dexmedetomidine as an adjunct to bupivacaine in ultrasound guided fascia iliaca compartment block for femur surgeries: A randomised control trial[J].Indian J Anaesth,2018,62(11):851-857.
[18] MALLIK A, CHANDA ML, LEVITIN D J.Anhedonia to music and mu-opioids: Evidence from the administration of naltrexone[J].Sci Rep,2017,7:41952.
[19] 潘闰梅,黄继梅,肖虹.中医五音疗法对患者围术期焦虑状态干预效果的临床研究[J].现代医院,2024,24(1):156-158.
[20] 冯雪竹,李喆,王可,等.中医五音疗法治疗抑郁障碍及相关症状的进展[J].中国药物依赖性杂志,2022,31(4):271-275.