鸡尾酒疗法对全膝关节置换术后皮温的影响

发布时间：2018-05-06 17:08

本文选题：全膝关节置换 + 鸡尾酒疗法　；参考：《中国矫形外科杂志》2017年18期

【摘要】：[目的]探讨人工全膝关节置换术后,鸡尾酒局部镇痛对患者皮温及术后疼痛评分的影响以及膝关节皮温变化曲线的意义。[方法]2015年10月~2016年6月收集78例拟行初次单侧人工全膝关节置换术的膝骨性关节炎患者,随机分为鸡尾酒组与常规组,每组39例。鸡尾酒组患者术中膝关节周围注射鸡尾酒式镇痛药物并采用分段阻滞,即术野显露时及关闭关节囊前分别注射鸡尾酒25 ml,而常规组术中不做任何处理。所有患者术前术后处理方案均一致。比较两组术后4、8、12h静息时及术后24、48、72 h活动时疼痛视觉模拟评分(visual analogue scale,VAS)、双侧膝关节皮温、膝关节最大被动活动度(range of motion,ROM)以及术后追加止痛药的情况。[结果]鸡尾酒组的VAS评分显著低于常规组(P0.05);术后1周ROM均优于常规组;鸡尾酒组双侧平均皮温在前3 d较常规组有所降低,且术后第5~7 d两组患者膝关节皮温差达到峰值。[结论]鸡尾酒镇痛能够降低全膝关节置换术后膝关节局部皮温和疼痛,显著提高了患者术后活动度。皮温作为一个较VAS评分更加客观的指标可能术后炎症控制方面有着独到的作用。
[Abstract]:[objective] to investigate the effect of cocktail local analgesia on skin temperature and postoperative pain score after total knee arthroplasty and the significance of knee joint skin temperature curve. [methods] from October 2015 to June 2016, 78 patients with knee osteoarthritis undergoing the first unilateral total knee arthroplasty were randomly divided into cocktail group and routine group with 39 cases in each group. Cocktails were injected into the knee around the knee of the patients in the cocktail group and adopted segmental block, that is, 25 ml cocktails were injected during the exposure of the surgical field and before the closure of the articular capsule, while in the routine group, no treatment was performed during the operation. All the patients had the same treatment plan before and after operation. The visual analogue scale and skin temperature of bilateral knee joint and the maximal passive motion of knee joint were compared between the two groups at the rest time of 812 hours after operation and the visual analogue scale score at 24 minutes and 72 hours after operation, as well as the addition of pain relievers after operation. [results] the VAS score of the cocktail group was significantly lower than that of the routine group (P 0.05), the ROM of the cocktail group was better than that of the routine group 1 week after operation, the average skin temperature of both sides in the cocktail group was lower than that of the routine group on the first 3 days, and the skin temperature difference of the knee joint reached the peak value in the two groups on the 5th and 7th day after operation. [conclusion] Cocktail analgesia can reduce the local skin mild pain after total knee arthroplasty, and improve the postoperative activity of the patients. As a more objective index than VAS score, skin temperature may play a unique role in postoperative inflammation control.
【作者单位】：山东大学附属省立医院关节外科;
【分类号】：R687.4

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