畢曄 趙秋華
【摘要】 目的:探討多模式鎮(zhèn)痛在全膝關節(jié)置換術(shù)中的應用效果。方法:選取筆者所在醫(yī)院2018年11月-2019年11月收治的62例人工全膝關節(jié)置換術(shù)患者作為研究對象,按照隨機數(shù)字表法將其分為對照組(21例)和觀察組(41例)。對照組采用靜脈自控鎮(zhèn)痛泵,觀察組采用多模式鎮(zhèn)痛。比較兩組術(shù)后12、24、48 h VAS評分、關節(jié)活動度。結(jié)果:觀察組術(shù)后12、24、48 h VAS評分均明顯低于對照組,差異有統(tǒng)計學意義(P<0.05)。觀察組術(shù)后12、24、48 h 關節(jié)活動度明顯大于對照組,差異有統(tǒng)計學意義(P<0.05)。結(jié)論:全膝關節(jié)置換術(shù)中采用多模式鎮(zhèn)痛可有效緩解疼痛,促進膝關節(jié)恢復,從而有效提升患者生活質(zhì)量,值得臨床大力推廣使用。
【關鍵詞】 多模式鎮(zhèn)痛 全膝關節(jié)置換術(shù) VAS評分 臨床效果
doi:10.14033/j.cnki.cfmr.2020.18.024 文獻標識碼 B 文章編號 1674-6805(2020)18-00-02
Study on the Application of Multimodal Analgesia in Total Knee Arthroplasty/BI Ye, ZHAO Qiuhua. //Chinese and Foreign Medical Research, 2020, 18(18): -57
[Abstract] Objective: To explore the effect of multimodal analgesia in total knee arthroplasty. Method: A total of 62 patients with artificial total knee arthroplasty who were admitted in our hospital from November 2018 to November 2019 were selected as the research object, and they were divided into the control group (21 cases) and the observation group (41 cases) according to the random number table method. The control group adopted intravenous controlled analgesia pump, and the observation group adopted multimodal analgesia. The VAS scores and joint mobility at 12, 24 and 48 h after surgery were compared between the two groups. Result: The VAS scores at 12, 24 and 48 h after surgery in the observation group were significantly lower than those in the control group, the differences were statistically significant (P<0.05). The joint mobility at 12, 24 and 48 h after surgery in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.05). Conclusion: Multimodal analgesia in total knee arthroplasty can effectively relieve pain, promote knee joint recovery and thus effectively improve patients quality of life, which is worthy of clinical application.
[Key words] Multimodal analgesia Total knee arthroplasty VAS score Clinical effect
First-authors address: Shijingshan Teaching Hospital, Capital Medical University, Beijing 100043, China
膝骨關節(jié)炎(KOA)是關節(jié)退行性疾病,多發(fā)于中老年人,關節(jié)軟骨退化磨損丟失同時關節(jié)周緣及軟骨下骨出現(xiàn)骨質(zhì)增生,致病因素尚不明確[1]。近年來關節(jié)置換術(shù)技術(shù)快速發(fā)展,在治療終末期KOA中得到認可,但圍手術(shù)期疼痛控制仍是需要解決的關鍵問題。傳統(tǒng)的單獨藥物鎮(zhèn)痛易造成諸多不良反應,隨著多模式鎮(zhèn)痛方案的研究越來越受到重視,在減少副作用、改善術(shù)后早期疼痛中有重要作用,為了進一步研究多模式鎮(zhèn)痛方案效果,本研究特選取筆者所在醫(yī)院62例全膝關節(jié)置換術(shù)患者進行研究,具體報告如下。
1 資料與方法
1.1 一般資料
選取筆者所在醫(yī)院2018年11月-2019年11月收治的62例人工全膝關節(jié)置換術(shù)患者作為研究對象。納入標準:符合膝關節(jié)炎癥,精神正常、表達清晰、臨床資料完整。排除標準:血壓控制不穩(wěn)定、合并其他部位骨折、病情危重、過敏體質(zhì)患者。按照隨機數(shù)字表法將其分為對照組(21例)和觀察組(41例)。對照組男11例,女10例;年齡62~78歲,平均(66.05±10.02)歲;體重(63.54±10.49)kg。觀察組男23例,女18例;年齡60~79歲,平均(65.11±11.24)歲;體重(64.25±11.02)kg。兩組患者基礎資料比較差異無統(tǒng)計學意義(P>0.05),有可比性。本次研究獲得醫(yī)院倫理委員會批準,患者及家屬知情同意并簽署知情同意書。