| 吴金丽,曾祥刚,周 菁,吕 洁,姚 茵.连续股神经阻滞联合帕瑞昔布对全膝置换患者术后镇痛效果观察[J].,2017,17(24):4770-4774 |
| 连续股神经阻滞联合帕瑞昔布对全膝置换患者术后镇痛效果观察 |
| Analgesic Effect of Continuous Femoral Nerve Block Combined with Parecoxib on Patients Undergoing Total Knee Replacement Surgery |
| 投稿时间：2017-03-02 修订日期：2017-03-27 |
| DOI：10.13241/j.cnki.pmb.2017.24.042 |
| 中文关键词: 全膝关节置换术 连续股神经阻滞 帕瑞昔布 关节功能 镇痛 |
| 英文关键词: Total knee arthroplasty Continuous femoral nerve block Parecoxib Joint function Analgesia |
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| 中文摘要: |
| 摘要 目的：探讨连续股神经阻滞（CFNB）联合帕瑞昔布对全膝关节置换术（TKA）患者术后镇痛效果。方法：选择2015年1月至2016年12月间我院行择期单侧TKA治疗的患者100例，按照随机数字表法分为对照组和研究组，每组各50例。两组患者术后分别接受CFNB和CFNB联合帕瑞昔布镇痛，镇痛时间2 d。观察两组患者术后6 h、12 h、24 h、48 h静息状态和运动状态视觉模拟疼痛评分（VAS）以及术后不良反应发生率。并于术前1 d、术后1 d、2 d、3 d应用美国特种外科医院膝关节评分表（HSS）评定两组患者膝关节功能。结果：术后6 h、12 h、24 h、48 h 研究组患者静息状态VAS评分和运动状态VAS评分显著低于对照组患者（P＜0.05）。两组恶心/呕吐、呼吸抑制、导管相关问题、尿潴留发生率比较无统计学差异（P>0.05）。两组患者术前1dHSS评分比较无统计学差异（P>0.05），术后1 d、术后2 d、术后3 d两组患者HSS评分均较术前1 d显著升高，且研究组患者HSS评分显著高于对照组（P<0.05）。结论：CFNB联合帕瑞昔布具有镇痛效果好、安全可靠的优点，应用TKA术后镇痛有利于患者早期进行膝关节功能锻炼，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the postoperative analgesia effect of continuous femoral nerve block (CFNB) combined with parecoxib on the patients with Total knee arthroplasty (TKA). Methods: A total of 100 patients, who underwent unilateral TKA in Affiliated Hospital of Guizhou Medical University from January 2015 to December 2016, were selected and randomly divided into study group(n=50) and control group(n=50). After TKA, the patients of two groups were received CFNB, CFNB combined with parecoxib analgesia respectively, analgesic time was 2 days. The visual analogue pain scores (VAS) of the patients of two groups at rest and during exercise and the incidence of postoperative adverse reactions were observed at 6h, 12 h, 24 h, 48 h after operation. The Hospital Special Surgery knee score (HSS) was used to evaluate the joint function of patients in the two groups 1 d before operation and 1 d, 2 d, 3 d after operation. Results: Resting state VAS and motion state VAS in the study group were significantly lower than those in the control group 6 h, 12 h, 24 h, and 48 h after operation (P<0.05). There were no significant differences in the incidence of nausea / vomiting, respiratory depression, catheter related problems, and urinary retention between the two groups (P>0.05). There was no significant difference in HSS score between the two groups 1 d before operation（P>0.05）. The HSS scores of the patients in the two groups 1 d, 2 d, 3 d after operation were significantly higher than those 1d before operation, and the HSS scores of the patients in the study group were significantly higher than those in the control group (P<0.05). Conclusion: CFNB combined with parecoxib has the advantages of good analgesic effect and safety for postoperative analgesia of the patients undergoing TKA, which is good for the patients' early knee joint function exercise and is worthy of clinical promotion. |
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