多模式超前镇痛对THA术后患者功能康复的影响及效果分析

Analysis of impact of multimodal preemptive analgesia on functional rehabilitation of patients after THA

目的：研究多模式超前镇痛对人工全髋关节置换术患者功能康复的镇痛效果观察及分析。方法：选择2011年1～2012年12月期间80例行人工全髋关节置换术的患者，按手术日期随机分为观察组（多模式超前镇痛组）和对照组。观察组中，有2例患者未手术，有2例患者改行其他手术，共有36例纳入研究；对照组中有4例未手术，3例改行其他手术，因此，共有33例纳入研究。观察组患者术前给予关节腔周围鸡尾酒样注射帕瑞昔布钠40mg以及关节周围注射盐酸罗哌卡因注射液100mg；对照组给予常规治疗术后均接受硬膜外自控镇痛。比较2组患者的VAS评分、功能锻炼（关节活动度、直腿抬高、术后行走）和依从性情况。结果：观察组与对照组相比，差异有显著意义（P〈0．05）。结论：多模式超前镇痛对人工全髋关节置换术患者功能康复的镇痛效果良好，不但能改善手术后的整体疗效，更能促进髋关节功能恢复，增加患者术后功能康复的依从性，对患者早日康复起着重要的作用。

Objective： To analyze the impact of multimodal preemptive analgesia on functional rehabilitation of patients after total hip arthroplasty（THA）. Methods：From January 2011 to December 2012, 80 patients after THA were selected for this study. Based on date of sur- geries , these patients were randomly divided into the observation （multimodal analgesia）group and the control group. In the observation group , there were two cases of patients without surgeries and two cases of patients were diverted into other surgeries. A total of 36 patients were in- cluded in this study. In the control group ,there were also four cases of patients without surgeries and three cases of patients were diverted into other surgeries. The number of patients was 33 in this group. The patients of observation group received the preoperative cocktail injection with Parry Past Bouna 40mg around the joint cavity and periarticular injection with ropivacaine hydrochloride 100mg around the joint. In the control group , patients were given postoperative conventional treatment of self - controlled epidural analgesia. The VAS scores, functional rehabilitation （range of motion, straight leg raising, postoperative walking）and compliance of patients were observed and compared between the two different groups. Results：There were significant differences between the observation and control group （P 〈 0.05 ）. Conclusion：Multimo- dal analgesia may play an important roles in the early recoveries of patients after TNA . It should be not only improved the overall efficacy of post -operation ,but also promoted the functional rehabilitation of patients ,and increased their compliances.