| 章沁丹,祝 平,张立红,杨慧慧,尤武林,周红梅.超声引导下隐神经联合IPACK阻滞对老年全膝关节置换术患者应激反应、炎性细胞因子及膝关节活动度的影响[J].,2023,(22):4299-4303 |
| 超声引导下隐神经联合IPACK阻滞对老年全膝关节置换术患者应激反应、炎性细胞因子及膝关节活动度的影响 |
| Effects of Ultrasound-guided Saphenous Nerve Combined with IPACK Block on Stress Response, Inflammatory Cytokines and Knee Joint Range of Motion in Elderly Patients Undergoing Total Knee Arthroplasty |
| 投稿时间：2023-05-03 修订日期：2023-05-25 |
| DOI：10.13241/j.cnki.pmb.2023.22.020 |
| 中文关键词: 老年 全膝关节置换术 超声引导 IPACK 隐神经 应激反应 膝关节活动度 炎性细胞因子 |
| 英文关键词: Elderly Total knee arthroplasty Ultrasound-guided IPACK Saphenous nerve Stress response Knee joint range of motion Inflammatory cytokines |
| 基金项目:江苏省中医药科技发展计划项目（YB201943） |
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| 中文摘要: |
| 摘要 目的：探讨超声引导下隐神经联合腘动脉与膝关节后囊间隙（IPACK）阻滞对老年全膝关节置换术（TKA）患者应激反应、炎性细胞因子及膝关节活动度的影响。方法：根据随机数字表法，将无锡市中医医院2021年3月~2022年9月期间收治的102例初次行TKA的老年患者分为观察组（超声引导下隐神经联合IPACK阻滞镇痛处理）和对照组（超声引导下隐神经镇痛处理），每组各51例。对比两组疼痛情况、炎性细胞因子、应激反应指标、不良反应发生率、膝关节活动度。结果：观察组术后6 h、术后12 h、术后24 h视觉模拟评分法（VAS）评分低于对照组（P<0.05）。观察组术后48 h肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-1β、β-淀粉样蛋白（Aβ）低于对照组（P<0.05）。观察组术后48 h血管紧张素Ⅱ（AngⅡ）、皮质醇（COR）低于对照组（P<0.05）。观察组术后24 h、术后48 h膝关节活动度大于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：超声引导下隐神经联合IPACK阻滞用于TKA患者，具有较好的镇痛效果，可减轻应激反应，抑制炎性细胞因子过度分泌，改善膝关节活动度，麻醉效果较好。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of ultrasound-guided saphenous nerve combine with interspace between the popliteal artery and the posterior capsule of the knee (IPACK) block on stress response, inflammatory cytokines and knee joint range of motion in elderly patients undergoing total knee arthroplasty (TKA). Methods: According to the random number table method, 102 elderly patients with initial TKA who were admitted to Wuxi Traditional Chinese Medicine Hospital from March 2021 to September 2022 were divided into observation group (treated with analgesia of ultrasound-guided saphenous nerve combined with IPACK block) and control group (treated with analgesia of ultrasound-guided saphenous nerve), 51 cases per group. The pain conditions, inflammatory cytokines, stress response indicators, incidence of adverse reactions and knee joint range of motion were compared between two groups. Results: The visual analogue scale (VAS) scores in observation group were lower than those in control group 6h after operation, 12 h after operation and 24 h after operation(P<0.05). The tumor necrosis factor-α(TNF-α), interleukin (IL)-6, IL-1β and β-amyloid (Aβ) in observation group were lower than those in control group 48 h after operation(P<0.05). The angiotensin Ⅱ (AngⅡ) and cortisol (COR) in observation group were lower than those in control group 48 h after operation(P<0.05). The knee joint range of motion in observation group was higher than that in control group 24 h after operation and 48 h after operation(P<0.05). There was no difference in the incidence of adverse reactions between two groups(P>0.05). Conclusion: Ultrasound-guided saphenous nerve combine with IPACK block in patients with TKA, which has a good analgesic effect, can alleviate stress response, inhibit excessive secretion of inflammatory cytokines, improve knee joint range of motion, and has a good anesthetic effect. |
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