膝关节置换应用甲基泼尼松龙对术后恶心呕吐和疼痛的影响及安全性评估

发布时间：2018-04-19 04:00

本文选题：关节成形术 + 置换　；参考：《中国组织工程研究》2017年03期

【摘要】：背景:目前地塞米松已普遍应用到骨科大手术围手术期中,用于减少术后疼痛及恶心呕吐发生,但国内对于甲基泼尼松龙减少单侧全膝关节置换后恶心呕吐和疼痛的研究报道较少。目的:探讨单侧全膝关节置换围手术期应用甲基泼尼松龙对于术后恶心呕吐和疼痛的影响及安全性评估。方法:单侧膝关节置换的患者共86例,随机分为2组:甲基泼尼松龙组患者置换中及置换后24 h内分别给予甲基泼尼松龙40 mg静脉滴注;对照组相应时间给予等量生理盐水静滴。观察记录两组患者术后0-6 h,6-24 h,24-48 h,48-72 h 4个不同时间段的术后恶心呕吐发生次数及置换后0-72 h总发生率,记录置换后6,24,48,72 h膝关节目测疼痛目测类比评分及置换后第3天的膝关节功能评分,检测C-反应蛋白值及空腹血糖。随访6个月复查并记录2组患者置换后不良反应发生情况。结果与结论:(1)甲基泼尼松龙组患者置换后0-72 h总的术后恶心呕吐发生率及置换后6,24 h的恶心呕吐发生率均显著低于对照组(P0.05);(2)甲基泼尼松龙组置换后6,24 h疼痛评分(VAS)均显著低于对照组(P0.05);(3)置换后甲基泼尼松龙组的膝关节活动度KSS评分显著高于对照组(P0.05);(4)2组患者置换前后的C-反应蛋白、血糖差异无显著性意义(P0.05);(5)2组患者术后术后随访3月发现手术切口均一期愈合,均未发生术后感染等并发症。(6)结果表明,单侧全膝关节置换围手术期应用甲基泼尼松龙能够明显减少术后恶心呕吐和疼痛,同时不增加置换后感染等并发症的发生。
[Abstract]:Background: at present, dexamethasone has been widely applied to the Department of orthopedics surgery during the perioperative period, to reduce the occurrence of postoperative pain and nausea and vomiting, but domestic methylprednisolone for reducing unilateral total knee arthroplasty reported nausea and vomiting and pain less. Objective: To investigate the effect of unilateral total knee arthroplasty perioperative application of methylprednisolone for effect nausea and vomiting and pain and safety assessment after surgery. Methods: unilateral knee replacement patients with a total of 86 cases were randomly divided into 2 groups: 40 were given methylprednisolone intravenous infusion of Mg 24 h methyl prednisolone group replacement and replacement; the control group were given normal saline infusion time were observed. Records of two groups of patients after 0-6 h, 6-24 h, 24-48 h, 48-72 h 4 different period of postoperative nausea and vomiting after the replacement of 0-72 times and the total incidence rate of H, recorded after the replacement of 6,24,48,72 H knee pain visual analogue score and visual replacement third days after the knee joint function score, the detection value of C- reactive protein and fasting blood glucose. 6 months follow-up review and record the occurrence of adverse reactions in 2 groups of patients. Results and conclusion: (1) 6,24 h the occurrence of nausea and vomiting in patients after replacement of methylprednisolone 0-72 of the total h of the incidence of postoperative nausea and vomiting and the replacement rate were significantly lower than control group (P0.05); (2) methylprednisolone group after the replacement of 6,24 h pain score (VAS) were significantly lower than the control group (P0.05); (3) after the replacement of the knee joint activities of Kakip Nixonn dragon group KSS scores were significantly higher the control group (P0.05); (4) C- reactive protein before and after the 2 groups of patients, there was no significant difference in blood glucose (P0.05); (5) 2 groups of patients with postoperative follow-up in March found that surgery incision healed, no postoperative complications such as infection. The results show that the single (6) Perioperative application of methylprednisolone in total knee arthroplasty can significantly reduce postoperative nausea and vomiting and pain without increasing complications such as infection after replacement.

【作者单位】：青岛大学医学院附属医院关节外科;
【分类号】：R687.4

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