摘要
目的观察酮咯酸氨丁三醇静脉滴注与肌内注射对老年膝关节置换患者术后的镇痛效果及对康复进程的影响。方法回顾性选取2021年6月至2022年10月在中国人民解放军联勤保障部队第九〇一医院行膝关节置换手术治疗的80例老年膝关节炎患者为研究对象,根据酮咯酸氨丁三醇不同给药方式分为两组,其中对照组35例采用肌内注射方式给药,观察组45例采用静脉滴注方式给药。记录两组用药前、用药30 min、3 h、12 h、24 h视觉模拟评分法(VAS)评分、舒适(BCS)评分变化,检测两组用药前、用药24 h炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-8]水平变化,比较两组康复指标、镇痛补救例数,统计两组不良反应发生情况。结果用药30 min、3 h、12 h、24 h时,两组VAS评分均较用药前下降,BCS评分均较用药前升高,观察组用药30 min、3 h时VAS评分分别为(3.12±0.78)、(2.33±0.47)分,低于对照组[(5.05±1.16)、(2.56±0.51)分],观察组BCS评分分别为(1.98±0.24)、(2.61±0.25)分,高于对照组[(1.55±0.23)、(2.42±0.24)分],差异均有统计学意义(P<0.05);但用药12、24 h时观察组VAS评分、BCS评分与对照组比较,差异均无统计学意义(P>0.05)。用药24 h时,两组TNF-α、IL-1β、IL-8水平较用药前下降,且观察组TNF-α、IL-1β、IL-8水平分别为(3.37±1.08)pg/mL、(58.45±6.98)ng/L、(32.12±4.55)pg/mL,均低于对照组[(3.65±1.14)pg/mL、(62.78±7.02)ng/L、(36.23±5.14)pg/mL],差异均有统计学意义(P<0.05)。观察组术后首次下床时间、排气时间分别为(16.33±3.07)、(18.66±3.46)h,均短于对照组[(18.14±3.89)、(21.96±4.12)h],观察组镇痛补救患者比率为6.67%,低于对照组(22.86%),差异均有统计学意义(P<0.05)。观察组累计不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论酮咯酸氨丁三醇采用静脉滴注方式给药较肌内注射方式镇痛效果更好,有利于膝关节置换手术患�
Objective To observe the analgesic effect of ketorolac tromethamine intravenous drip and intramuscular injection on elderly patients with knee joint replacement and its influence on the rehabilitation process.Methods From June 2021 to October 2022,eighty elderly patients with knee arthritis who underwent knee replacement surgery in 901st Hospital,Joint Logistic Support Force,Chinese People's Liberation Army were selected as subjects.According to the different administration methods of ketorolac tromethamine,they were divided into two groups,35 patients in the control group were administered by intramuscular injection,and 45 patients in the observation group were administered by intravenous drip.Visual analog scale(VAS)scores and comfort(BCS)scores of the two groups were recorded before medication,30 min,3 h 12 h and 24 h,and the rehabilitation indexes and the number of analgesic relief cases were compared between the two groups.The changes of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-1β and IL-8]were detected before and 24 h after medication in the two groups,and the adverse reactions of the two groups were analyzed.Results At 30 min,3 h,12 h and 24 h after administration,the VAS scores of the two groups were lower than those before administration,and the BCS scores were higher than those before administration,the VAS scores in the observation group at 30 min and 3 h after administration were(3.12±0.78)and(2.33±0.47)points,respectively,which were lower than those in the control group[(5.05±1.16)and(2.56±0.51)points],and the BCS scores in the observation group were(1.98±0.24),(2.61±0.25)points,respectively,which were higher than those in the control group[(1.55±0.23),(2.42±0.24)points],the differences were statistically significant(P<0.05);but there were no statistically significant difference between the VAS score and BCS score of the observation group and the control group at 12 and 24 h after administration(P>0.05).The levels of TNF-α,IL-1β,IL-8 in two groups decreased com
作者
汪晓龙
张晶晶
刘涛
WANG Xiao-long;ZHANG Jing-jing;LIU Tao(Department of Anesthesiology,901st Hospital,Joint Logistic Support Force,Chinese People's Liberation Army,Hefei Anhui 230031,China;Department of Anesthesiology,The Second People's Hospital of Wuhu,East China Normal University,Wuhu Anhui 241001,China)
出处
《临床和实验医学杂志》
2023年第9期1003-1006,共4页
Journal of Clinical and Experimental Medicine
基金
安徽省自然科学基金项目(编号:1908085MH251)。
关键词
酮咯酸氨丁三醇
静脉滴注
肌内注射
膝关节置换手术
康复
镇痛
Ketorolac tromethamine
Intravenous drip
Intramuscular injection
Knee replacement surgery
Recovery
Analgesia
