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定点注射和非定点注射镇痛药物在膝关节置换术中效果对比分析

Comparative analysis of efficacy of site-directed and non-site-directed analgesics in knee replacement
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摘要 目的:观察行膝关节置换术患者术中分别给予定点、非定点注射镇痛药物的临床效果.方法:选取2015年1月-2018年6月期间入院行膝关节置换治疗的73例患者为本次观察对象,所有患者均给予全膝关节置换术治疗以及术中关节囊周围局部镇痛,按数字表法随机分组,对照组人数35例(35膝)术中行关节囊周围非定点注射镇痛药,观察组人数38例(38膝)术中给予关节囊定点注射镇痛药,比较2组术后不同时间段(清醒时、6小时、12小时、24小时、48小时及初次下床时)患者疼痛评分差异,统计术后不良反应发生及术后2天、5天、8天及11天膝关节活动度变化,观察2组镇痛药使用量、镇痛效果、不良反应差异.结果:清醒及术后6、12、24、48小时以及初次下床时,观察2组疼痛评分组间比较无明显差异,P>0.05;观察组不良反应发生率为7.9%,低于对照组20.0%,P<0.05;术后12小时、24小时、48小时观察组药使用量低于对照组,P<0.05;术后2、5天观察组膝关节活动度高于对照组,P<0.05.结论:TKA术中采用关节局部注射镇痛药,术后镇痛效果理想,其中定点注射镇痛不良反应少,术后镇痛泵用药量显著减少,患者术后早期膝关节活动度恢复好,建议在行TKA术中采用定点注射进行局部镇痛. Objective:To observe the clinical effects of fixed-point and non-fixed-point injection of analgesic drugs in patients un dergoing knee joint replacement.Methods:Selection methods from January 2015 to June 2015 inhospital during the period of the knee joint replacement treatment for 73 patients in the observation object,all the patients were given total knee replacement treatment and intra operative joint capsule around the local analgesia,according to the digital meter method randomized,control group number 35 cases(35)the bank of China joint capsule around the fixed point injection pain relievers,observation group number 38 cases(38)intraoperative give joint capsule fixed-point injection pain relievers,compared two groups of postoperative different times(waking,6 h,12 h,24 h,48 h and bed for the first time)in patients with pain score difference,The postoperative adverse reactions and the changes of knee joint activity 2 days,5 days,8 days and 11 days after the operation were calculated,and the analgesic dosage,analgesic effect and adverse reactions of the two groups were observed.Results:there was no significant difference between the two groups in pain assessment at 6,12,24,48h after sobriety and the first time after surgery,P>0.05.Hie incidence of adverse reactions in the observation group was 7.9%lower than that in the control group,20.0%,P<0.05.The drug dosage of the observation group at 12h,24h and 48h after surgery was lower than that of the control group,P<0.05.Knee joint activity was higher in the observation group 2 and 5 days after surgery than in the control group,P<0.05.Conclusion:local injection of joint analgesics was used in TKA surgery,and the postoperative analgesic effect was ide al,in which the adverse reaction of fixed-point injection was less,the dosage of analgesic pump was significantly reduced,and the early postoperative knee joint activity was recovered well.Therefore,it might be recommended to use fixed-point injection for local analgesic in TKA surgery.
作者 余斌 郑金财 张文标 伍志健 梁显球 YU bin;ZHENG Jin-cai;ZHANG Wen-biao(The Guangdong Zhaoqing Second People's Hospital 526060)
出处 《中国伤残医学》 2019年第12期13-15,共3页 Chinese Journal of Trauma and Disability Medicine
关键词 镇痛药 镇痛 骨性关节炎 膝关节置换术 注射 Analgesic drugs Analgesia Osteoarthritis Knee arthroplasty The injection
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