多模式镇痛对股骨近端骨折围手术期镇痛效果的评价

The Effectsof Different Modesof Mechanical Ventilation on Respiratory Function in Obese Patients Undergoing Gynecological Laparoscopic Operation

目的观察多模式镇痛在股骨近端骨折围手术期疼痛治疗中的作用。方法 2011年6月~2013年8月我院骨科收治的股骨近端骨折并行骨折切开复位内固定术的患者共37例,根据患者住院时自行选择的手术组而划分为多模式镇痛组16例和常规镇痛对照组21例。观察两组术后的6 h、24 h、和48 h疼痛的VAS评分,住院日数和镇痛治疗的不良反应;并对结果进行统计学分析。结果多模式组和常规镇痛组术后6、24、48 h疼痛的VAS评分分别是：5.3±1.7和6.5±1.1、4.0±0.9和5.1±1.3、3.3±0.7和3.7±0.6;患者自控镇痛泵（patient controlled analgesia,PCA）在术后6 h、术后24 h、术后48 h内使用次数分别为：2.4±1.5、5.0±2.1、7.4±2.7和3.3±1.8、5.9±1.8、9.4±2.6次。两组相比较,在术后各时间点的VAS评分、术后止痛药物使用量存在统计学意义（p〈0.05）。结论多模式镇痛对下肢骨折术后镇痛较常规镇痛方式更能减轻患者疼痛、和镇痛药物的使用次数,减少镇痛药物副作用的发生。

Objective Preemptive analgesia was observed in the treatment of lower extremity fractures role of postoperative pain.Methods From June 2012 to August 2013 in our hospital orthopedic lower limb fractures were treated with open reduction and internal fixation of patients with a total 37 cases, according to their own choice when hospitalization and surgery group is divided into 16 cases of preemptiveanalgesiaand conventional town pain control group 21 cases. Wereobserved after 6 hours, 24 hours, and 48 hours of pain VAS score, hospital stay and analgesic treatment of adversereactions; and theresults were statistically analyzed. Results Preemptive analgesia group and routine postoperative analgesia group 6,24,48 hour pain VAS scores were： 5.3 ± 1.7 and 6.5 ± 1.1,4.0 ± 0.9 and 5.1 ±1.3,3.3 ± 0.7 and 3.7 ± 0.6; patient- controlled analgesiapump（patient controlled analgesia, PCA） after 6 hours and after 24 hours, the frequency of use within 48 hours after surgery were： 2.4 ± 1.5,5.0 ± 2.1,7.4 ± 2.7 and 3.3 ± 1.8,5.9 ± 1.8, 9.4 ± 2.6 times.Compared the two groups in postoperative VAS scores at each time point, postoperative pain medication usage（p 0.05）. Conclusion Preemptive analgesia for postoperative pain lower limb fracture better than conventional analgesia reduce pain, and analgesic medication usefrequency, toreducetheincidenceof sideeffectsof analgesic drugs.