摘要
目的比较术前腰丛联合坐骨神经阻滞与术前注射帕瑞昔布钠对腰椎融合患者术后康复的影响。方法回顾性分析2018年2月~2019年2月在重庆医科大学附属第一医院接受腰椎融合手术患者60例,采用随机数字表法分为实验组30例(术前腰丛联合坐骨神经阻滞)和对照组30例(术前注射帕瑞昔布钠)。比较两组术前、术后不同时间点视觉模拟评分(VAS评分)、腰椎功能障碍指数(ODI),并进一步比较两组术后下地时间、术后PCIA使用情况、住院时间及费用。结果实验组术后第1、3、7天VAS评分较对照组短,差异有统计学意义(P<0.05);实验组术后1周和1月ODI评分优于对照组,差异有统计学意义(P<0.05);实验组下地时间(3.03±0.37)d、PCIA使用量(66.48±10.47)ml、使用频次(7.43±2.17)次、住院时间(6.03±2.15)d、住院费用(3.75±0.49)万元,低于对照组的(5.67±1.28)d、(103.56±14.83)ml、(24.27±8.39)次、(9.67±4.69)d、(5.03±1.06)万元,差异具有统计学意义(P<0.05)。结论腰丛联合坐骨神经阻滞在腰椎融合术后早期镇痛及腰椎功能改善方面效果显著,有利于患者术后快速康复,减轻医疗负担。
Objective To compare the effects of preoperative lumbar plexus combined with sciatic nerve block and preoperative injection of parecoxib sodium on postoperative rehabilitation of lumbar fusion patients.Methods A retrospective analysis was performed on 60 patients who underwent lumbar fusion surgery in the firs affiliated hospital of chongqing medical university from February 2018 to February 2019.The patients were randomly divided in the experimental group(30 cases of preoperative lumbar plexus combined with sciatic nerve block)and the control group(30 cases of preoperative injection of parecoxib sodium).Visual analog score(VAS)and lumbar dysfunction index(ODI)were compared between the two groups at different time points before and after surgery and the postoperative time to land,postoperative PCIA use,length of stay and cost were further compared between the two groups.Results VAS scores on day 1,3 and 7 were shorter in the experimental group than in the control group,with statistically significant differences(P<0.05).The improvement of lumbar function in the experimental group 1 week and 1 month after surgery was better than that in the control group,and the difference was statistically significant(P<0.05).In the experimental group,the time spent on the ground(3.03±0.37)d,the amount of PCIA used(66.48±10.47)ml,the frequency of use(7.43±2.17),the length of stay(6.03±2.15)d,and the cost of stay(3.75±0.49)yuan were lower than those in the control group(5.67±1.28)d,(103.56±14.83)ml,(24.27±8.39),(9.67±4.69)d,(5.03±10,60)yuan,and the differe nceswere statistically significant(P<0.05).Conclusion lumbar plexus combined with sciatic nerve block is effective in early analgesia and improvement of lumbar function after lumbar fusion.
作者
杨正洋
沈皆亮
郝杰
张晓军
YANG Zheng-yang;SHEN Jie-liang;HAO Jie;ZHANG Xiao-jun(Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,china)
出处
《医学信息》
2020年第6期76-78,共3页
Journal of Medical Information
关键词
腰丛联合坐骨神经阻滞
帕瑞昔布钠
腰椎融合术
术后加速康复
Lumbar plexus combined with sciatic nerve block
Parecoxib sodium injection
lumbar fusion
Enhanced recovery after surgery
