摘要
目的观察耳穴贴压对高龄股骨颈骨折患者人工股骨头置换围手术期的镇痛效果。方法选取2017年6月—2020年6月期间苏州市吴江区中医医院(扬州大学医学院附属医院)收治的70例股骨颈骨折行人工股骨头置换术的高龄患者纳为研究对象,采用随机数字表法将患者随机分为对照组与研究组,每组各35例。两组患者均采用多模式镇痛方案,研究组在此基础上辅助耳穴贴压镇痛。对两组患者各时间节点静息状态与运动状态下疼痛视觉模拟评分(Visual analogue scale,VAS)、镇痛药物使用情况、Harris评分、Barthel指数评分、循环呼吸系统指标[收缩压(Systolic blood pressure,SBP)、心率(Heart rate,HR)、呼吸频率(Respiratory rate,RR)、血氧饱和度(Oxyhemoglobin saturation,SpO_(2))、每分钟通气量(Minute ventilation,MV)]及血清细胞因子水平[血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)]进行分析比较。结果术后两组患者静息与运动VAS评分均较术前下降,差异有统计学意义(P<0.05);术后1~3 d研究组静息VAS评分均较对照组明显降低,差异有统计学意义(P<0.05)。术后1~5 d研究组运动VAS评分均较对照组明显降低,差异有统计学意义(P<0.05),研究组术后首次按压镇痛泵时间明显晚于对照组,差异有统计学意义(P<0.05),24 h内镇痛药物使用量与追加镇痛次数均明显低于对照组,差异有统计学意义(P<0.05)。术前两组患者Harris评分、Barthel指数比较,差异无统计学意义(P>0.05);术后7 d研究组Harris评分、Barthel指数均明显高于对照组,差异有统计学意义(P<0.05)。术后12 h、24 h两组患者SBP、HR、RR指标均高于术前,而SpO_(2)、MV低于术前,差异有统计学意义(P<0.05);术后48 h两组患者SBP、HR指标均低于术后24 h,而SpO_(2)、MV、RR指标均高于术后24 h,差异有统计学意义(P<0.05);术后48 h研究组SB
Objective To observe the analgesic effect of auricular acupoint compression in the perioperative period of femoral head replacement in elderly patients with femoral neck fracture.Methods Seventy elderly patients with femoral neck fracture admitted to Wujiang Hospital of Traditional Chinese Medicine for femoral head replacement from June 2017 to June 2020 were enrolled and divided into an observation group(n=35)and a control group(n=35)by a randomnumber table.All patients were treated under multi-mode analgesia scheme,and those in the observation group received additional auricularacupoint compression.The visual analog scale(VAS)score,medication of analgesic drugs,Harris score,Barthel index score,circulatory respiratory system indexes[systolic blood pressure(SBP),heart rate(HR),respiratory rate(RR),oxyhemoglobin saturation(SpO_(2)),and minute ventilation(MV)],and serum cytokine levels[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-1β(IL-1β)]were analyzed and compared between the two groups at each time point in the resting state and exercise state.Results The VAS scores of the two groups after operation in resting state and exercise state were both lower than those before operation(P<0.05);the resting VAS scores of the observation group were lower than those of the control group 1-3 days after operation(P<0.05).The VAS scores of the observation group in the exercise state were lower than those of the control group 1-5 days after operation(P<0.05).The first time of pressing the PCA pump in the observation group after operation was later than that in the control group(P<0.05).The dosage and the number of additional analgesic drugs in the observation group within 12 h were lower than those in the control group(P<0.05).No significant difference in Harris score and Barthel index was observed in the two groups before operation(P>0.05).The Harris score and Barthel index of the observation group were higher than those of the control group 7 days after operation(P<0.05).SBP,HR,and RR of the two grou
作者
李翰林
徐浩
张伟中
陈亮
顾勇
范伟华
顾春妹
邱燕
LI Han-lin;XU Hao;ZHANG Wei-zhong;CHEN Liang;GU Yong;FAN Wei-hua;GU Chun-mei;QIU Yan(Wujiang Hospital of Traditional Chinese Medicine(The Second People's Hospital of Wujiang District,Affiliated Hospital of Medical College of Yangzhou University),Suzhou Jiangsu 215221;The First Afiliated Hospital of Soochow University,Suzhou Jiangsu 215006)
出处
《世界中西医结合杂志》
2022年第4期796-801,共6页
World Journal of Integrated Traditional and Western Medicine
基金
江苏省苏州市民生科技医疗卫生应用基础研究(SYSD2017204)。
关键词
耳穴贴压
股骨颈骨折
人工股骨头置换
围手术期
镇痛
Auricular Point Compression
Femoral Neck Fracture
Artificial Femoral Head Replacement
Perioperative Period
Analgesia
