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超声引导下持续股神经阻滞在全膝关节置换术后镇痛中的临床应用

Clinical Application of Continuous Femoral Nerve Block Guided by Ultrasound in Postoperative Analgesia after Total Knee Arthroplasty
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摘要 目的:探讨超声引导下持续股神经阻滞(CFNB)在全膝关节置换术(TKA)后镇痛中的临床应用价值。方法:选择2018年1月-2020年12月拟在我院行TKA术治疗的90例患者,按随机数字表法分为观察组、对照A组、对照B组,各30例。术后观察组使用CFNB,对照A组使用静脉镇痛(PCIA),对照B组使用硬膜外镇痛(PCEA)。对比各组术后静息状态时、持续被动运动时疼痛程度、患肢股四头肌肌力、不良反应及对镇痛的满意度。结果:观察组术后6h、24h、48h、72h时静息状态时疼痛评分与术后第3d持续被动运动时疼痛评分均低于对照A组、对照B组,差异有统计学意义(P<0.05);观察组术后24h、48h、72h患肢股四头肌肌力评级、不良反应发生率均低于对照A组、对照B组,患者对镇痛的总满意度均高于对照A组、对照B组,差异有统计学意义(P<0.05)。结论:CFNB可有效减轻TKA术后疼痛程度,减少不良反应发生率,提高患者对镇痛的满意度,但会造成患肢股四头肌肌力不足。 Objective:To investigate the clinical value of continuous femoral nerve block(CFNB)guided by ultrasound in postoperative analgesia after total knee arthroplasty(TKA).Methods:90 patients who planned to receive TKA in our hospital from January 2018 to December 2020 were selected and divided into observation group,control group A and control group B according to random number table method,with 30 patients in each group.Postoperative CFNB was used in observation group,intravenous analgesia(PCIA)was used in control group A,and epidural analgesia(PCEA)was used in control group B.The pain degree,muscle strength of quadriceps femoris of affected limb,adverse reactions and satisfaction with analgesia were compared in each group during resting state and continuous passive exercise.Results:The pain scores in the observation group at 6h,24h,48h and 72h after surgery and at the third day of continuous passive movement were lower than those in the control group A and control group B,with statistical significance(P<0.05).The observation group was lower than control group A and control group B at 24h,48h and 72h after surgery,and the total satisfaction of patients with analgesia was higher than control group A and control group B,with statistical significance(P<0.05).Conclusion:CFNB can effectively reduce the degree of pain after TKA,reduce the incidence of adverse reactions and improve patients'satisfaction with analgesia,but it has a certain impact on the muscle strength of quadriceps femoris in the affected limb.
作者 徐江叶 XYU Jiang-ye(Department of Anesthesiology,the 5th Division Hospital of Xinjiang Production and Construction Corps,Xinjiang Bole,833400)
出处 《农垦医学》 2022年第3期206-208,212,共4页 Journal of Nongken Medicine
基金 新疆生产建设兵团第五师双河市科技攻关与成果转化(2018F003)。
关键词 全膝关节置换术 持续股神经阻滞 超声 硬膜外镇痛 静脉镇痛 Total knee arthroplasty Persistent femoral nerve block Ultrasound Epidural analgesia Intravenous analgesia
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