局部注射维生素C方案预防复杂区域疼痛综合征的效果分析

Analysis of the effect of topical vitamin C injection regimen for the prevention of complex regional pain syndrome

目的探讨局部注射维生素C方案预防复杂区域疼痛综合征(CRPS)的效果。方法80例接受桡骨远端骨折切开复位内固定患者,根据预防方案不同分为A组、B组、C组、D组,各20例。A组在缝合完毕后于骨折断端局部注射5 ml 0.9%生理盐水,B组局部注射125 mg维生素C+5 ml 0.9%生理盐水,C组局部注射250 mg维生素C+5 ml 0.9%生理盐水,D组局部注射500 mg维生素C+5 ml 0.9%生理盐水。比较四组CRPS发生率,干预前后的视觉模拟评分法(VAS)评分,疼痛缓解效果。结果A组CRPS发生率为50.00%,B组CRPS发生率为20.00%,C组CRPS发生率为0,D组CRPS发生率为0。B组、C组、D组CRPS发生率低于A组,C组、D组CRPS发生率低于B组,差异有统计学意义(P<0.05)。干预后,四组VAS评分均较干预前降低,且B组VAS评分(3.52±1.01)分、C组(3.21±1.22)分、D组(1.52±0.25)分低于A组的(4.25±1.07)分,D组低于B组、C组,差异有统计学意义(P<0.05)。干预后,B组、C组VAS评分比较差异无统计学意义(P>0.05)。A组疼痛缓解优良率为35.00%,B组为70.00%,C组为70.00%,D组为95.00%。B组、C组、D组疼痛缓解优良率高于A组,D组高于B组、C组,差异有统计学意义(P<0.05)。B组、C组的疼痛缓解优良率比较,差异无统计学意义(P>0.05)。结论对桡骨远端骨折切开复位内固定患者在切口缝合完毕后于骨折断端局部注射500 mg维生素C+5 ml 0.9%生理盐水能缓解患者疼痛程度,降低CRPS发生率,值得进一步在临床推广以及应用。

Objective To discuss the effect of topical vitamin C injection regimen for the prevention of complex regional pain syndrome(CRPS).Methods A total of 80 patients who received open reduction and internal fixation for distal radius fractures were divided into group A,group B,group C and group D according to different prevention programs,with 20 cases in each group.Group A was locally injected with 5 ml 0.9%normal saline at the broken ends of fractured bone after sature,group B was injected with 125 mg vitamin C+5 ml 0.9%normal saline,group C was locally injected with 250 mg vitamin C+5 ml 0.9%normal saline,and group D was locally injected with 500 mg vitamin C+5 ml 0.9%normal saline.The incidence of CRPS,visual analogue scale(VAS)scores before and after intervention,and the pain relief effect of the four groups were compared.Results The incidence of CRPS was 50.00%in group A,20.00%in group B,0 in group C and 0 in group D,and the difference was statistically significant(P<0.05).The incidence of CRPS in group B,group C and group D was lower than that in group A,and the incidence of CRPS in group C and group D was lower than that in group B.The difference was statistically significant(P<0.05).After intervention,the VAS scores in the four groups were lower than those before intervention;the VAS score was(3.52±1.01)points in group B,(3.21±1.22)points in group C and(1.52±0.25)points in group D,which was lower than(4.25±1.07)points in group A;the VAS score in group D was lower than that in group B and group C;the differences were statistically significant(P<0.05).After intervention,there was no statistically significant difference in VAS score between group B and group C(P>0.05).The excellent-effective rate of pain relief was 35.00%in group A,70.00%in group B,70.00%in group C and 95.00%in group D.The excellent-effective rate of pain relief in group B,group C and group D was higher than that in group A,and group D was higher than that in group B and group C,the difference was statistically significant(P<0.05).There was no statistically significant difference in excellent-effective rate of pain relief between group B and group C(P>0.05).Conclusion For patients after open reduction and internal fixation of distal radius fracture,the local injection of 500 mg vitamin C+5 ml 0.9%normal saline at the broken ends of fractured bone can relieve patients'pain level,and reduce the incidence of CRPS,which is worthy of further promotion and application in clinical practice.