“鸡尾酒”疗法在人工全膝关节置换中的应用进展

Progress of"cocktail"therapy in total knee arthroplasty

人工全膝关节置换术(TKA)是治疗骨关节炎终末期的最有效方式,但是由于手术过程中需要广泛软组织暴露、大量的滑膜切除,并且需要大面积的截骨,所以术后常伴有剧烈的疼痛及失血,对术后康复及功能锻炼都有严重的影响。“鸡尾酒”(Cocktail)疗法主要是通过几种药物的联合(配方药物)注射关节周围,从而达到预防和控制术后疼痛的目的,且随着“鸡尾酒”配方的改进,其对控制围术期出血也不断显示出良好的效果,而疼痛及出血的控制会使患者术后功能锻炼进一步获得改善,有利于患者的快速康复。现将近年来国内外有关“鸡尾酒”疗法在人工全膝关节置换方面的研究进展和疗效综述如下。

Total knee arthroplasty(TKA)is the most effective way to treat end⁃stage osteoarthritis.However,because of extensive soft tissue exposure,massive synovectomy and large area osteotomy,during the operation,there will be severe postoperative pain and blood loss,which has a serious impact on postoperative rehabilitation and functional exercise.“Cocktail”therapy is mainly used to prevent and control postoperative pain by reducing the stimulation of surgical wound to pain,and with the improve⁃ment of“cocktail”formula,it also has a good effect on controlling bleeding.The clinical application of cocktail can effectively control the postoperative pain and bleeding volume of patients,and the control of pain and bleeding will further improve the postoperative functional exercise of patients,which is con⁃ducive to the rapid recovery of patients.In recent years,the research progress and efficacy of“cocktail”therapy in total knee arthroplasty at home and abroad are summarized as follows.