程控脉冲式泵入技术在膝关节镜清理术后镇痛中的疗效观察

Effect of programmable pulse pump technique on the analgesia after knee arthroscopic debridement

目的探讨程控脉冲式泵入技术在膝关节镜清理术后镇痛中的疗效。方法选取2017年6月至2019年6月本院膝关节镜清理术后患者100例,依据随机数字表分为程控组和自控组,每组50例,自控组术后采用常规自控镇痛(PCA),程控组术后采用程控脉冲式泵入技术镇痛,比较两组镇痛效果[视觉模拟评分法(VAS)]、PCA使用情况、关节活动度、不良反应、股四头肌肌力。结果程控组术后12、24、48 h的VAS评分明显低于自控组,差异有统计学意义(P<0.05);程控组PCA按压次数、用药量明显低于自控组,差异有统计学意义(P<0.05);程控组术后12、24、48 h膝关节活动度明显高于自控组,差异有统计学意义(P<0.05);程控组不良反应发生率明显低于自控组,差异有统计学意义(P<0.05);程控组和自控组术后12、24、48 h股四头肌肌力比较,差异无统计学意义(P> 0.05)。结论程控脉冲式泵入技术可有效改善膝关节镜清理术后患者镇痛效果,减少了PCA使用,有利于促进患者关节活动度恢复及减少其不良反应,且不影响患者股四头肌肌力,值得临床推广。

Objective To discuss the effect of programmable pulse pump technique on the analgesia after knee arthroscopic debridement.Methods From June 2017 to June 2019,100 patients with knee arthroscopic debridement in our hospital were selected,they were divided into program-controlled group and self controlled group according to the random number table,50 cases in each group. The self-controlled group was given routine patients controlled analgesia( PCA) after operation, the program-controlled group was given programmable pulse pump technique analgesia after operation, the analgesic effect [visual analogue scale( VAS) ],PCA usage,range of motion of joints,adverse reactions and quadriceps femoris muscle strength were compared between the two groups.Results The VAS scores of 12,24 and 48 hours after operation in the program-controlled group were significantly lower than those in the self-controlled group,the difference was statistically significant( P<0.05).The number of PCA pressing and dosage in the program-controlled group were significantly lower than that in the self-controlled group,the difference was statistically significant( P<0.05).The knee joint activity in the program-controlled group was significantly higher than that in the self-controlled group at 12, 24 and 48 hours after operation, the difference was statistically significant( P < 0. 05). The incidence of adverse reactions in the program-controlled group was significantly lower than that in the self-controlled group,the difference was statistically significant( P<0.05).There was no significant difference in quadriceps femoris muscle strength between the program-contrlled group and the self-controlled group at 12,24 and 48 hours after operation( P>0.05). Conclusions Programmable pulse pump technique can effectively improve the analgesic effect of patients after knee arthroscopic debridement,it can reduce the use of PCA,it is helpful to promote the recovery of joint activity and reduce adverse reactions of patients,without affecting quadriceps femoris muscle strength,it’s worth for further clinical promotion.