多模式镇痛在全膝关节置换病人术后镇痛的临床研究

发布时间：2018-05-10 18:28

本文选题：多模式镇痛 + 全膝关节置换术　；参考：《青海大学》2017年硕士论文

【摘要】：研究目的为行全膝关节置换术术后的患者提供经济、有效的术后镇痛模式,并为术后患者早期功能锻炼及远期康复提供更好的临床指导。研究方法采用前瞻性随机对照研究的方法,对2015年11月至2016年11月在青大附院关节科初次行单侧TKA的80例患者,进行多模式镇痛的临床研究。采用病历资料调查、临床检查结合的方式完成资料收集。采用SPSS19.0统计软件进行数据分析。对于连续型变量,结果以均数±标准差(mean±SD)表示;分类变量以例数(百分比)(N;%)表示。重复测量计量资料比较采用重复测量资料的方差分析,组间比较采用成组设计资料的t检验,以P0.05为差异具有统计学意义。结果1.试验组和对照组术后静息与活动VAS评分比较均具有统计学差异(F分组=24.596、28.475,P0.001),术后6、12、24、48、72h及出院时试验组静息与活动VAS评分均明显低于对照组;静息与活动VAS评分均随着时间增加而减小(F时间=31.210、46.894,P0.001);试验组术后静息与活动VAS评分减少的幅度均明显大于对照组(F交互=9.972、15.819,P0.001)。2.试验组和对照组术后ROM比较具有统计学差异(F分组=37.814,P0.001),术后24、48、72h试验组ROM均明显高于对照组;术后ROM随着时间增加而增大(F时间=51.657,P0.001);试验组术后ROM增大的幅度明显大于对照组(F交互=19.234,P0.001)。3.试验组镇痛不良反应的发生率低于对照组且具有统计学差异(χ2=8.658,P=0.003)。结论多模式镇痛可以降低TKA患者术后疼痛,改善TKA患者术后膝关节的活动度,并降低镇痛不良反应的发生率,值得临床推广使用。
[Abstract]:Objective to provide an economical and effective mode of postoperative analgesia for patients undergoing total knee arthroplasty, and to provide better clinical guidance for early functional exercise and long-term rehabilitation. Methods A prospective randomized controlled trial was conducted in 80 patients with unilateral TKA from November 2015 to November 2016. Data collection was completed by means of medical records investigation and clinical examination. SPSS19.0 statistical software was used to analyze the data. For continuous variables, the results are expressed as mean 卤standard deviation (mean 卤SD), and classified variables are expressed as the number of examples (percentage). The repeated measurement data were compared by the analysis of variance of repeated measurement data, and the t-test of group design data was used in the comparison between groups. The difference was statistically significant with P0.05. Result 1. The VAS scores of rest and activity were significantly different between the experimental group and the control group. The VAS scores of rest and activity in the test group were significantly lower than those in the control group. The VAS scores of rest and activity decreased with the increase of time, and the VAS scores of rest and activity in the experimental group were significantly higher than those in the control group. There were significant differences in postoperative ROM between the trial group and the control group. The ROM of the trial group was significantly higher than that of the control group at 24: 48 h after operation, and the postoperative ROM time increased with the increase of time, and the increase of ROM in the test group was significantly greater than that in the control group (19.234P0.001p0.001 路3). The incidence of analgesic adverse reactions in the trial group was lower than that in the control group (蠂 ~ 2 = 8.658). Conclusion Multi-mode analgesia can reduce postoperative pain in patients with TKA, improve the motion of knee joint in patients with TKA, and reduce the incidence of adverse effects of analgesia. It is worth popularizing in clinic.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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