鸡尾酒疗法联合股神经阻滞在全膝关节置换术中的应用效果分析

Analysis of the effect of cocktail therapy combined with femoral nerve block in total knee arthroplasty

目的探讨鸡尾酒疗法联合股神经阻滞在全膝关节置换术(total knee arthroplasty,TKA)中的应用效果。方法选取2017年1月至2019年1月首都医科大学附属北京天坛医院收治的行TKA患者86例为研究对象,根据随机数字表法将其分为观察组(43例)和对照组(43例),对照组患者术中予以超声引导下股神经阻滞,观察组患者在股神经阻滞基础上实施鸡尾酒疗法,比较两组患者术后6、12、24、36 h的视觉模拟评分法(visual analogue scale,VAS)评分,术后2周、1个月、6个月的膝关节学会评分(Knee Society score,KSS)及不良反应发生率。结果术后6、12、24、36 h,静息状态和运动状态下观察组患者VAS评分均显著低于对照组(均P<0.05);术后1个月和6个月,观察组患者KSS均显著高于对照组(均P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论鸡尾酒疗法联合股神经阻滞对TKA术后镇痛效果良好,可促进患者膝关节功能恢复,且安全性较高。

Objective To investigate the effect of cocktail therapy combined with femoral nerve block in total knee arthroplasty(TKA).Method A total of 86 patients treated with TKA in Beijing Tiantan Hospital,Capital Medical University from January 2017 to January 2019 were selected as research objects,and they were divided into observation group(43 cases)and control group(43 cases)according to the random number table method.Patients in control group were given ultrasound-guided femoral nerve block during operation,while patients in observation group were treated with cocktail therapy on the basis of femoral nerve block.The visual analogue scale(VAS)score at 6,12,24 and 36 hours after surgery,Knee Society score(KSS)at 2 weeks,1 month and 6 months after surgery and the incidence of adverse reaction were compared between the two groups.Result The VAS score of observation group were significantly lower than those in control group under resting state and exercise state at 6,12,24 and 36 hours after operation(all P<0.05).KSS score of observation group were significantly higher than those control group at 1 month and 6 months after operation(all P<0.05).The incidence of adverse reaction in the two groups was not statistically significant(P>0.05).Conclusion Cocktail therapy combined with femoral nerve block has a good analgesic effect and promotes the recovery of knee joint function after TKA with high safety.