膝关节置换术后连续股神经阻滞导管规范化管理的效果分析

Effect of Standardized Management of Continuous Femoral Nerve Block Catheter after Knee Replacement

目的探讨膝关节置换术后连续股神经阻滞导管规范化管理的效果。方法2018年5月至2019年2月,便利抽样法选择某院骨科患者为对照组(n=110),由护士采用常规护理方法护理股神经阻滞导管;2019年3-12月,同法选择该院骨科患者为观察组(n=100),采用护士、医生、麻醉师三方联合规范化管理模式管理股神经阻滞导管。比较两组患者疼痛程度、膝关节活动度、导管脱管和外渗等情况发生率。结果不同组别与不同时间数字疼痛评分(numerical rating scale,NRS)交互作用差异有统计学意义(F交互=3.450,P<0.05)。在术后1.24.48 h.两组患者NRS评分差异均有统计学意义(均P<0.05)。不同组别与不同时间关节活动度交互作用差异有统计学意义(F交互=879.200,P交互<0.05)。术后1.3.7d,两组患者膝关节活动度的差异均有统计学意义(均P<0.05)。观察组脱管、外渗等情况均低于对照组,差异均有统计学意义(均P<0.05)。结论膝关节置换术后连续股神经阻滞导管规范化管理,有利于患者术后镇痛,能促进早期功能锻炼和肢体活动度恢复,值得临床推广应用。

Objective To study the effect of standardized management for continuous femoral nerve block catheter.Methods From May 2018 to February 2019,110 patients from Department of Arthropathy were selected as the control group(n=110),whose femoral nerve block catheters were taken care by routine nursing procedure of the department of orthopedics nurses.From March to December 2019,100 the patients from Department of Arthropathy were selected as the experimental group(n=100),and the catheters were taken care by standardized management team,which includes nurses,doctors and anesthesiologists.The incidence of pain,range of motion of knee joint,extubation and exosmosis were evaluated and compared between the two groups.Results NRS score interaction dfference in diferent groups and diferent time was stitically significant(F=3.450,P<0.05).The analgesic effeet in 1,24.48 h alfter surgery in experiment group is staitically significant than control group(all P<0.05).Range of notion of the knee interaction diference in different groups and different time was statistically significant(F=879.200,P<0.05).Meanwhile,the range of motion of the knee in 1,3,7 d after surgery in experiment group was also staistically significant(all P<0.05).The extubation and exosmosis rate in experiment group was lower than control group(all P<0.05).Conclusions Standardized man-agement of femoral nerve block catheter is more conducive to postoperative analgesia than routine method,which promotes patients early functional recovery thus can be promoted in clinical treatment.