股神经阻滞用于全膝关节置换术患者术后镇痛效果观察

发布时间：2018-10-16 10:26

【摘要】：目的观察全膝关节置换术患者采取连续股神经阻滞进行术后镇痛的效果。方法将280例行全膝关节置换术患者随机分为观察组和对照组各140例,观察组于术后采取连续股神经阻滞镇痛,对照组于术后采取静脉镇痛。采用VAS评价两组术后疼痛程度,酶联免疫吸附法检测血清炎症因子IL-1β、TNF-α水平,流式细胞仪检测细胞免疫功能(CD4~+T细胞和CD8~+T细胞的比例)。结果术后6、12、24、48 h时,观察组静息状态下和活动状态下的VAS均低于对照组(P均0.05);术后24、48 h时,观察组血清IL-1β、TNF-α水平低于对照组,外周血CD4~+T细胞比例高于对照组、CD8~+T细胞比例低于对照组(P均0.05)。结论全膝关节置换术后使用连续股神经阻滞的镇痛效果较静脉镇痛更理想,其机制可能与抑制炎症反应、改善细胞免疫功能有关。
[Abstract]:Objective to observe the effect of postoperative analgesia by continuous femoral nerve block in patients undergoing total knee arthroplasty. Methods 280 cases of total knee arthroplasty were randomly divided into observation group (n = 140) and control group (n = 140). The observation group received continuous femoral nerve block analgesia and the control group received intravenous analgesia after operation. The degree of postoperative pain was evaluated by VAS, the levels of serum inflammatory cytokines IL-1 尾 and TNF- 伪 were detected by enzyme-linked immunosorbent assay (Elisa), and the cellular immune function (proportion of CD4~ T cells and CD8~ T cells) was detected by flow cytometry. Results the levels of VAS in the observation group were lower than those in the control group at 24 hours after operation, and the levels of serum IL-1 尾 and TNF- 伪 in the observation group were lower than those in the control group at 24 hours after the operation (P < 0. 05), and the levels of serum IL-1 尾 and TNF- 伪 in the observation group were lower than those in the control group at 24 h after operation. The percentage of CD4~ T cells and CD8~ T cells in peripheral blood were higher than those in control group (P < 0. 05). Conclusion the analgesic effect of continuous femoral nerve block after total knee arthroplasty is better than that of intravenous analgesia. The mechanism may be related to the inhibition of inflammation and the improvement of cellular immune function.
【作者单位】：成都体育学院附属体育医院;四川省骨科医院;
【分类号】：R614

【相似文献】