摘要
目的探讨关节周围注射镇痛药物和自控静脉镇痛(PCIA)联合应用于行全膝关节置换术后的老年患者中的镇痛效果。方法随机抽取2019年1月至2022年1月武警山西总队医院行全膝关节置换术的老年患者60例,根据不同镇痛方法划分组别,其中,行关节周围注射镇痛药物+PCIA的31例患者为研究组,单一行PCIA方法镇痛的29例患者作为对照组,比较分析两组各项镇痛指标统计学情况。结果两组患者平均手术时间经统计学比较无明显差异(P>0.05);但研究组术后首次下床时间较对照组的时间更短(P<0.05);研究组镇痛泵按压次数较对照组更少(P<0.05)。不同时间段的静息状态下,研究组的VAS评分相较于对照组的评分会更低(P<0.05);不同时间段,研究组的HSS评分相较于对照组的评分会更高(P<0.05);两组术后6 h、24 h、48 h时间段,Cor、TNF-α和CPR等应激水平较术前均有明显上升的趋势,且研究组Cor、TNF-α和CPR水平相较于对照组更低(P<0.05);两组不良反应发生率比较无统计学意义(P>0.05)。结论将关节周围注射镇痛药物和PCIA联合运用到行全膝关节置换术后的老年患者中,能够最大限度改善患者疼痛症状。
Objective To study the analgesic effect of periarticular injection of analgesics and PCIA in the elderly patients after total knee arthroplasty in our hospital.Methods Sixty elderly patients who underwent total knee arthroplasty in our hospital from January 2019 to January 2022 were selected by digital random method,and divided into groups according to different analgesic methods.Among them,31 patients who received periarticular injection of analgesics+PCIA were used as the study group,and 29 patients who received PCIA alone as the control group.The statistics of various analgesic indicators in the two groups were compared and analyzed.Results There was no significant difference in the average operation time between the two groups(P>0.05).However,the first time of getting out of bed in the study group was shorter than that in the control group(P<0.05).The number of press of analgesia pump in the study group was less than that in the control group(P<0.05).The VAS score of the study group will be lower than that of the control group in different periods of rest(P<0.05).The HSS score of the study group will be higher than that of the control group in different time periods(P<0.05).Cor,TNF-α,CRP in the two group at 6 hours,24 hours and 48 hours after operation significantly higher than those before operation,the levels of Cor,TNF-α and CPR in the study group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of periarticular injection of analgesics and PCIA in the elderly patients after total knee arthroplasty can improve the pain symptoms of patients to the maximum extent.
作者
张黄丽
ZHANG Huangli(Department of Anesthesia,Shanxi Armed Police Corps Hospital,Taiyuan 030006,China)
出处
《中国医药指南》
2023年第13期83-85,89,共4页
Guide of China Medicine
关键词
关节周围注射镇痛药物
PCIA
联合
老年
全膝关节置换
术后镇痛
Periarticular injection of analgesics
PCIA
Union
Old age
Total knee replacement
Postoperative analgesia
