摘要
目的分析酮咯酸氨丁三醇经不同给药方式对老年股骨粗隆间骨折术后快速康复的影响。方法150例采用股骨近端抗旋髓内钉(PFNA)治疗的老年股骨粗隆间骨折患者作为研究对象,按照术后不同给药方式分成A组(90例)和B组(60例)。两组均给予酮咯酸氨丁三醇治疗,A组采用静脉滴注方式给药,B组采用肌内注射方式给药。比较两组患者用药后不同时间点疼痛程度、视觉模拟评分法(VAS)评分均值-用药时间关系、并发症发生情况及下地活动时间。结果两组用药前及用药1、3、5 hVAS评分比较差异无统计学意义(P>0.05);用药30 min,A组VAS评分(3.77±1.32)分低于B组的(5.88±0.96)分,差异有统计学意义(P<0.05)。A组注射痛、头痛、食欲缺乏、便秘、肌间静脉血栓发生率分别为0、0、3.3%、12.2%、1.1%,B组分别为80.0%、1.7%、3.3%、11.7%、1.7%;A组注射痛发生率明显低于B组,差异有统计学意义(P<0.05)。A组下地活动时间为(41.19±5.90)h,短于B组的(46.23±5.09)h,差异有统计学意义(P<0.05)。结论酮咯酸氨丁三醇具有良好的镇痛效果,其不同给药方式对老年股骨粗隆间骨折术后康复有一定影响,采用静脉滴注方式可能会给患者带来更好的康复体验,加快术后康复。
Objective To analyze the effect on enhanced recovery after surgery of intertrochanteric fracture in elderly patients by different administrations of ketorolac tromethamine.Methods A total of 150 elderly patients with intertrochanteric fracture treated by proximal femoral nail anti-rotation(PFNA)as study subjects were divided into group A(90 cases)and group B(60 cases)by different administrations after operation.Both groups received ketorolac tromethamine for treatment.Group A was administered intravenously and group B was administered intramuscularly.The pain degree after medication at different time points,correlation between visual analogue scale(VAS)score and medication time,occurrence of complications and off-bed activity time were compared between the two groups.Results Before medication and after 1,3 and 5 h of medication,there was no statistically significant difference between the two groups(P>0.05).After 30 min of medication,the VAS score(3.77±1.32)points in group A was lower than(5.88±0.96)points in group B,and the difference was statistically significant(P<0.05).The incidence of injection pain,headache,anorexia,constipation and intramuscular venous thrombosis were 0,0,3.3%,12.2%and 1.1%respectively in group A,which were 80.0%,1.7%,3.3%,11.7%and 1.7%in group B.The incidence of injection pain in group A was obviously lower than that in group B,and the difference was statistically significant(P<0.05).The off-bed activity time was(41.19±5.90)h in group A,which was shorter than(46.23±5.09)h in group B,and the difference was statistically significant(P<0.05).Conclusion Ketorolac tromethamine has a good analgesic effect,and its different administration modes have certain influence on the postoperative rehabilitation of the elderly patients with intertrochanteric fracture of femur.Intravenous drip may bring better rehabilitation experience to the patients and enhance the postoperative rehabilitation.
作者
朱兵
裴保安
高万里
吴立生
孙怡
ZHU Bing;PEI Bao-an;GAO Wan-li(Traumatology Department,Linyi People’s Hospital,Linyi 276001,China)
出处
《中国实用医药》
2020年第5期104-106,共3页
China Practical Medicine
关键词
酮咯酸氨丁三醇
股骨粗隆间骨折
快速康复
Ketorolac tromethamine
Intertrochanteric fracture
Enhanced recovery
