老年全膝关节置换术患者疼痛管理的研究进展

Research progress of pain management in elderly patients undergoing total knee arthroplasty

伴随医学诊疗、卫生保健水平提升及人类寿命延长,人口老龄化相关问题逐渐凸显,如膝关节退行性变患者逐渐增多,严重降低老年患者日常生活质量。每年全球约60万人行全膝关节置换术(TKA)治疗,已成为治疗中重度骨关节炎的重要方法,可实现纠正关节畸形、改善功能的目的。但手术治疗并非此类疾病治疗的终结,术后伴发疼痛及行动不便等问题给患者带来了巨大心理压力,阻碍术后康复。疼痛如能合理、有效控制,将减少疼痛刺激造成的机体应激反应和继发性器官功能障碍。因此,全膝关节置换术后疼痛控制已成为临床治疗的重点内容。本文就TKA术后疼痛机制及疼痛管理方法最新进展进行综述。

Accompanying medical diagnosis and treatment、improvement of health care level and prolongation of human life,issues related to population ageing are becoming more and more prominent,such as the gradual increase of patients with degenerative knee degeneration,seriously reduce the quality of daily life of elderly patients.Annual Total knee arthroplasty(TKA)treatment for approximately 600,000 people worldwide,has become an important method for the treatment of moderate to severe osteoarthritis,can be achieved to correct joint deformities,improve the function of the purpose.But surgical treatment is not the end of treatment for such diseases,postoperative problems such as pain and mobility have brought great psychological pressure to patients,obstruction of early recovery after surgery.Reasonable and effective control of analgesia will reduce the stress response and secondary organ dysfunction caused by pain stimulation.So,Pain control after TKA has become the key content of clinical treatment.In this paper,the recent progress of postoperative pain mechanism and pain management methods in TKA was reviewed.