人工股骨头置换术中卵圆窝周围软组织去神经化对术后负重疼痛疗效的影响

Effect of Denervation of Soft Tissue Around Oval Fossa in Artificial Femoral Head Replacement on Post-operative Weight-bearing Pain

目的:研究人工股骨头置换术中卵圆窝周围软组织去神经化对术后负重疼痛的影响。方法:选择2017年8月-2018年10月在本院行人工股骨头置换术的150例患者为研究对象,按随机数字表法分为观察组和对照组,各75例,两组均进行人工股骨头置换术,观察组术中进行卵圆窝周围软组织去神经化。比较两组手术前与术后血清中疼痛介质、炎性应激指标、视觉模拟评分法(VAS)评分、髋关节功能优良率及并发症发生率。结果:术后24 h,两组各疼痛介质与炎性应激指标水平均明显高于术前(P<0.05),但观察组术后24 h的各疼痛介质与炎性应激指标均明显低于对照组(P<0.05)。观察组术后1、3、6个月VAS评分和术后6个月髋关节功能优良率均低于对照组(P<0.05)。观察组术后感染、疼痛及下肢血栓静脉炎发生率明显低于对照组(P<0.05)。结论:在人工股骨头置换术中进行卵圆窝周围软组织去神经化可有效缓解股骨颈骨折患者的疼痛程度及由疼痛激发的全身炎症,促进患者关节功能恢复,降低术后的并发症发生率。

Objective:To study the effect of denervation of soft tissue around oval fossa on weight-bearing pain after artificial femoral head replacement.Method:A total of 150 cases underwent artificial femoral head replacement in our hospital from August 2017 to October 2018 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,75 cases in each group.Both groups underwent artificial femoral head replacement,and the observation group was given denervation of soft tissue around the oval fossa during the surgery.The pain mediators,inflammatory stress index,visual analogue scale score(VAS),excellent and good hip function and complication rate were compared between the two groups before and after surgery.Result:24 h after surgery,the levels of pain mediators and inflammatory stress indicators in both groups were significantly higher than those before surgery(P<0.05),but the levels of pain mediators and inflammatory stress indicators in the observation group were significantly lower than those in the control group(P<0.05).The VAS scores at 1,3 and 6 months after surgery in the observation group and the excellent and good rate of hip function at 6 months after surgery were all lower than those in the control group(P<0.05).The incidence of postoperative infection,pain and lower limb thrombophlebitis in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:During artificial femoral head replacement,soft tissue denaturation around oval fossa can effectively relieve the pain degree of patients with femoral neck fracture and the systemic inflammation induced by pain,promote the recovery of joint function of patients,and reduce the incidence of postoperative complications.