自控镇痛泵在行肩关节松解治疗患者围手术期的应用研究

Application study of patient self-controlled analgesia pump in perioperative period of patients with shoulder joint lysis

目的探讨自控镇痛泵在行肩关节松解治疗患者围手术期的应用成效。方法收集2019年1月~2019年8月肩周炎患者28例,患者均为住院患者,并在疼痛科治疗室行B超引导下患侧肩关节松解术,术中置入臂丛神经置管,予缝针固定导管,臂丛置管接自控镇痛泵(patientcontrolled analgesia,PCA)镇痛。术后医务人员指导患者在疼痛发生时或在预行功能锻炼前,自行控制PCA给药镇痛。本调查记录并对比了患者在治疗前及出院当天的疼痛评分、肩关节活动度情况及整体临床疗效情况。结果与治疗前相比,PCA植入术后患者在出院当天的NRS评分明显降低(P<0.01);患者肩关节在前屈、后伸、外展、内旋、外旋5方面的关节活动度明显增大(P<0.01);患者治疗的总有效率达89.2%。结论PCA对肩关节松解治疗患者围手术期的镇痛,安全有效,不仅可有效的减轻患者疼痛,还有利于其肩关节功能的恢复。

Objective To investigate the effectiveness of the patient self-control analgesic pump in the treatment of patients with shoulder joint lysis during the perioperative period.Methods Collected 28 patients with scapulohumeral periarthritis from January 2019 to August 2019,all patients were hospitalized,and underwent ultrasound-guided lysis of the affected side shoulder joint in the treatment room of our pain department,and the arm was implanted during the operation.The plexus nerve was catheterized,the catheter was fixed with suture needles,and the brachial plexus catheter was connected to patient-controlled analgesia(PCA)for analgesia.Postoperative medical staff instruct patients to control PCA for analgesia when pain occurs in pre-function exercise.This survey records and compares the patients'pain scores,shoulder mobility and overall clinical efficacy before treatment and on the day of discharge.Results Compared with before treatment,the NRS score of patients after PCA implantation was significantly lower on the day of discharge(P<0.01);the patient's shoulder joints were having a good performance in flexion,extension,abduction,internal rotation,and external rotation,and the degree of activity increased significantly(P<0.01);the total effective rate of patient treatment reached 89.2%.Conclusion PCA is safe and effective for perioperative analgesia of patients with shoulder joint lysis treatment.It can not only effectively reduce the pain of patients,but also help the recovery of shoulder joint function.