胫腓神经麻醉下针刀治疗足跟痛的疗效观察

Efficacy Observation of Needle-Knife Therapy for Heel Pain Under Tibiofibular Nerve Anesthesia

目的:观察胫腓神经麻醉下采用针刀治疗足跟痛的临床疗效。方法:选取2019年6月-2021年6月收治的足跟痛患者110例作为研究对象,按照信封法原则将其分为常规组及试验组,各55例。常规组采用足底局部麻醉下针刀治疗,试验组接受胫腓神经麻醉下针刀治疗。对两组患者手术情况(麻醉起效时间、持续阻滞时间、拔管时间、下床活动时间),生活质量(SF-36)评分及不同时间段平均动脉压、心率进行比较。结果:试验组患者麻醉起效时间、持续阻滞时间、拔管时间、下床活动时间均优于常规组(P<0.05)。两组患者术后SF-36评分均优于术前,且试验组术后SF-36评分均优于常规组,差异有统计学意义(P<0.05)。两组入室时(T_(0))时平均动脉压、心率水平比较,差异无统计学意义(P>0.05);切皮前(T_(1))、手术15 min(T_(2))、手术30 min(T_(3))时试验组平均动脉压、心率水平均优于常规组,差异有统计学意义(P<0.05)。结论:足跟痛采用针刀手术治疗时给予胫腓神经麻醉更有利于稳定生命体征,提高麻醉效果,改善患者生活质量,值得推广应用。

Objective: To observe the clinical efficacy of needle-knife therapy under tibiofibular nerve anesthesia in the treatment of heel pain. Methods: A total of 110 patients with heel pain treated from June 2019 to June 2021 were selected as the research objects. They were divided into conventional group and experimental group according to the principle of envelope method, with 55 cases in each group. The conventional group was treated with needle-knife therapy under plantar local anesthesia, and the experimental group was treated with needle-knife therapy under tibiofibular nerve anesthesia. The surgical treatment(anesthesia onset time, sustained blockage time, extubation time, ambulation time), SF-36 score, blood pressure and heart rate at different time periods were compared between the two groups. Results: The anesthesia onset time, sustained blockage time, extubation time,ambulation time of patients in the experimental group were better than those in the control group(P<0.05). The postoperative SF-36 score in two groups was better than preoperative score, and the postoperative SF-36 score in the experimental group was better than that in the conventional group, with statistically significant difference(P<0.05). There was no significant difference in blood pressure and heart rate at T_(0) time between the two groups(P>0.05). At T_(1), T_(2), and T_(3), the blood pressure and heart rate of the experimental group were better than those of the conventional group, with statistically significant difference(P<0.05). Conclusion:The application of tibiofibular nerve anesthesia in the needle-knife operation therapy of heel pain is more conducive to stabilizing the signs, improving the anesthetic effect, and accordingly improving the quality of life of patients. It is worthy of popularization and application.