摘要
目的探讨超前镇痛在膝关节骨性关节炎患者行全膝关节置换术中应用的临床疗效。方法选取自2016年1月至2017年12月收治的80例膝关节骨性关节炎患者为研究对象,采用随机数字表法将患者为常规组(n=40)与超前镇痛组(n=40),两组患者均行全膝关节置换术。常规组患者术后给予塞来昔布200 mg,2次/d;在常规组基础上,超前镇痛组于术前30 min静脉滴注帕瑞昔布0.8 mg/kg。采用视觉模拟评分法(VAS)评估患者术前及术后6 h的疼痛程度;采用酶联免疫吸附试验法检测患者术前及术后6 h的血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平;采用膝关节纽约特种外科医院(HSS)评分评价患者术前及术后2周的膝关节功能。结果术前,两组患者VAS评分比较,差异无统计学意义(P>0.05)。术后6 h,两组患者VAS评分均较术前显著降低,且超前镇痛组VAS评分低于常规组,差异有统计学意义(P<0.05)。术后6 h,两组患者血清IL-6及TNF-α水平均较术前降低,且超前镇痛组患者血清IL-6及TNF-α水平均低于与常规组,差异均有统计学意义(P<0.05)。术后2周,患者膝关节HSS评分均明显高于术前,且超前镇痛组高于常规组,差异均有统计学意义(P<0.05)。结论帕瑞昔布作为超前镇痛剂能有效提高疼痛阈值,减轻膝关节骨性关节炎患者术后疼痛程度,抑制炎症反应,临床疗效较好。
Objective To investigate the clinical effect of preemptive analgesia in total knee arthroplasty(TKA)in patients with osteoarthritis of the knee.Methods A retrospective study was performed on 80 cases of patients with knee osteoarthritis who were admitted from January 2016 to December 2017.Patients were randomly divided into the conventional group(n=40)and the preemptive analgesia group(n=40),both groups of patients were performed TKA.Patients in the conventional group were given 200 mg celecoxib for 2 times/day.On the basis of the conventional group,the preemptive analgesia group of patients received intravenous infusion of 0.8 mg/kg of parecoxib 30 minutes before the operation.Visual analogue scale(VAS)was used to evaluate the degree of pain of the patients before and 6 hours after surgery.Serum levels of interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)before and 6 hours after operation were detected by Elisa.Knee function was evaluated by the New York hospital for special surgery(HSS)score before and 2 weeks after operation.Results Before surgery,VAS scores of the two groups were compared,and the difference was not statistically significant(P>0.05).At 6 hours after surgery,VAS scores in both groups were significantly lower than those before surgery,and VAS scores in the preemptive analgesia group were lower than those in the conventional group,with statistically significant difference(P<0.05).At 6 hours after surgery,serum IL-6 and TNF-αlevels in both groups were lower than those before surgery,and serum IL-6 and TNF-αlevels in the preemptive analgesia group were lower than those in the conventional group(P<0.05).Two weeks after the operation,the HSS score of the knee joint of the patients was significantly higher than that of the preoperative group,and that of the preemptive analgesia group was higher than that of the conventional group(P<0.05).Conclusion As a leading analgesic,parecoxib can effectively improve the pain threshold,reduce the postoperative pain level of patients with knee osteoarthritis,
作者
蔡楠楠
王沐
朱法政
周颖
任向焕
CAI Nan-nan;WANG Mu;ZHU Fa-zheng;ZHOU Ying;REN Xiang-huan(Department of Pharmacy,Langfang Fourth People's Hospital,Langfang 065700,China)
出处
《创伤与急危重病医学》
2020年第1期28-31,共4页
Trauma and Critical Care Medicine
基金
廊坊市科学技术研究与发展计划项目(2018013015)
关键词
结直肠肿瘤
术后肠梗阻
原因
对策超前镇痛
帕瑞昔布
膝关节骨性关节炎
全膝关节置换术
Colorectal carcinoma
Postoperative obstruction
Cause
Counterplan Preemptive analgesia
Parecoxib
Knee osteoarthritis
Total knee arthroplasty
