全膝关节置换术后三种镇痛方案的对比

发布时间：2018-06-01 01:01

本文选题：全膝关节置换 + 镇痛　；参考：《中国矫形外科杂志》2017年19期

【摘要】：[目的]评价不同镇痛方案在全膝关节置换术后的临床效果。[方法]全膝关节置换术90例,随机采用三组,分别采用"鸡尾酒"关节腔灌注(关节灌注组)、关节周围多点注射(多点注射组)及股神经阻滞(神经阻滞组),每组30例。比较三组间术后VAS评分、哌替啶使用例数、不良反应的发生和功能恢复情况。[结果]术后6 h及72 h,三组间VAS评分差异无统计学意义(P0.05);术后24 h时,神经阻滞组后关节囊疼痛明显,VAS评分高于其他两组,差异有统计学意义(P0.05)。术后加用哌替啶患者数三组间差异无统计学意义(P0.05)。不良反应三组间差异有统计意义(P0.05)。神经阻滞组诉股四头肌无力比例较高,自主直腿抬高及下地活动时间方面均不如其他两组,差异有统计学意义(P0.05)。术后3个月三组间HSS评分的差异无统计学意义(P0.05)。[结论]关节腔灌注"鸡尾酒"配方药物在全膝关节置换术后镇痛方面效果良好。可有效降低术后疼痛,且操作简单,在术后早期活动及不良反应发生率方面均有一定优势。
[Abstract]:Objective: to evaluate the clinical effect of different analgesic schemes after total knee arthroplasty. [methods] 90 cases of total knee arthroplasty were randomly treated with "cocktails" intraarticular perfusion (articular perfusion group), periarticular multi-point injection (multi-point injection group) and femoral nerve block (nerve block group, 30 cases in each group). Postoperative VAS scores, pethidine use, adverse reactions and functional recovery were compared among the three groups. [results] there was no significant difference in VAS score between the three groups at 6 and 72 hours after operation, but at 24 hours after operation, the score of posterior articular capsule pain in the nerve block group was significantly higher than that in the other two groups (P 0.05). There was no significant difference in the number of patients treated with pethidine after operation (P 0.05). The difference of adverse reactions among the three groups was statistically significant (P 0.05). The proportion of quadriceps muscle weakness in nerve block group was higher than that in the other two groups (P 0.05). There was no significant difference in HSS score between the three groups 3 months after operation (P 0.05). [conclusion] the "cocktail" formula for articular instillation is effective in analgesia after total knee arthroplasty. It can effectively reduce postoperative pain and is easy to operate. It has some advantages in early postoperative activity and incidence of adverse reactions.
【作者单位】：河南南阳市第一人民医院;山东文登整骨医院;
【分类号】：R687.4

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