微创膝关节及髋关节置换术后患者疼痛分析

Analysis of post-operative pain for patients with minimally invasive surgery of total knee replacement and total hip replacement

目的探讨微创人工膝、髋关节患者手术后疼痛及疼痛不良反应的差异。方法采纵贯式研究设计方式,以该院骨科150例接受人工膝、髋关节置换术患者为研究对象,分为全人工膝关节置换术(TKR)及全人工髋关节置换术(THR)两组。以结构式问卷、疼痛评估纪录包括疼痛影响项目及视觉模拟评分量表(VAS),收集术后3 d疼痛评估资料并进行分析。结果术后疼痛程度及疼痛不良反应发生率均随时间增加而降低(P<0.05);TKR组患者手术后疼痛程度高于THR组患者;MIS(微创)术式患者疼痛程度虽于术后24 h高于传统术式,但术后48和72 h疼痛程度已明显低于传统术式,MIS(微创)术式患者术后疼痛程度较低。两组患者疼痛的最主要不良反应均为不敢翻身,THR组术后疼痛不敢翻身发生率高于TKR组(t=15.62,P=0.000)。结论 VAS评分能够用于THR和TKR术后患者疼痛评价,其评价结果能够协助干预THR和TKR术后患者疼痛。

Objective To investigate the post-operative pain variance between patients receiving total knee replacement and total hip replacement.Methods A longitudinal study design was used with a sample of 150 subjects at a medical center in our hospital.The subjects were divided into two groups:one group received total knee replacement(TKR)and the other group had total hip replacement(THR).Structured questionnaires,pain assessment records regarding adverse effects due to pain and visual analog scale(VAS)were utilized for data collection and analysis for three post-operative days.Results The level of pain and occurrence of adverse effects due to pain decreased by time(P<0.05).The TKR group's pain level was higher than that of the THR group after surgery.Although the patients with minimally invasive surgery(MIS)had higher levels of pain compared with those who received traditional surgery during the post-operative 24 hours,the patients with MIS had significantly lower levels of pain 48 and 72 hours after surgery than the patients who had traditional surgery.In summary,patients with MIS had lower levels of pain.The main adverse reactions of pain in both groups were not to turn over,and the incidence of postoperative pain in THR group was higher than that in TKR group(t=15.62,P=0.000).Conclusion VAS can be used for patients'pain assessment after TKR and THR surgeries with the proper care measures provided.