多镇痛模式联合术后干预对高龄关节置换术患者术后感染及疼痛状态的比较研究

Comparative study of postoperative infection and pain in elderly patients undergoing joint replacement surgery with multiple analgesia mode combined with postoperative intervention

目的探讨多种镇痛干预联合术后干预对高龄关节置换术患者术后感染及疼痛状态的影响,为关节置换术后感染及镇痛提供参考依据。方法选择医院2013年1月-2015年12月关节置换术患者196例,随机单盲法分为观察组100例与对照组96例,观察组术后给予硬膜外自控镇痛联合局麻模式镇痛,对照组术后给予静脉外自控镇痛联合局麻镇痛模式镇痛,比较两组术后1、3、7、14d关节活动度情况。结果两组治疗期间各部位感染发生率对比,差异均无统计学意义,感染总发生率对比,差异有统计学意义(P<0.05);两组术后1、3、7、14d关节活动情况随着时间延长,均呈增高趋势(P<0.05);两组术后并发症比较,差异无统计学意义。结论高龄关节置换术患者给予自控镇痛、局麻镇痛联合术后干预可降低术后感染发生、降低术后疼痛状态,提高关节活动度,值得临床推广。

OBJECTIVE To investigate the effects of combined analgesia and peripheral joint intervention on postoperative infection and pain in elderly patients with joint replacement,so as to provide references for postoperative analgesia and infection.METHODS A total of 196 cases of patients undergoing joint replacement surgery from Jan.2013 to Dec.2015 were selected,and were divided into observation group（100cases）and control group（96cases）according to random single-blind method.Patients in observation group were given postoperative patient-controlled epidural analgesia combined with Cocktail analgesia,and in control group were given postoperative patient-controlled intravenous analgesia combined with local injection analgesia The degrees of joint motion were observed at1,3,7and 14 dafter operation.RESULTS During the treatment,there were no significant differences of infection rates of various sites between the two groups,and there had a significant difference of total infection rate between the two groups（P〈0.05）.After 1,3,7,14 days of operation,the joint activity of the two groups increased gradually with time（P〈0.05）.The postoperative complications of the two groups had no significant difference.CONCLUSIONPatient-controlled epidural analgesia and local injection analgesia combined with postoperative intervention in elderly patients undergoing joint replacement surgery can reduce the incidence of postoperative infection,reduce postoperative pain,and improve joint mobility,and it is worthy of clinical promotion.