关节腔注射药物与髂筋膜阻滞在全髋关节置换术后镇痛中的应用效果比较

Comparison of the application effect of intra-articular injection of drugs and iliac fascia block in analgesia after total hip arthroplasty

目的比较关节腔注射药物与髂筋膜阻滞在全髋关节置换术后镇痛中的应用效果。方法选取2020年5月至2022年5月本院收治的95例行全髋关节置换术的老年患者作为研究对象,根据镇痛方法不同将其分为对照组(48例)和研究组(47例)。对照组行髂筋膜阻滞镇痛,研究组行关节腔注射药物镇痛。比较两组的镇痛效果。结果术后,两组的皮质醇(Cor)、肾上腺素(E)及去甲肾上腺素(NE)水平均高于术前,但研究组低于对照组(P<0.05)。术后1、12、24、48 h,两组静息状态和运动状态下的视觉模拟量表(VAS)评分均低于术前,且研究组运动状态下的VAS评分低于对照组(P<0.05);术前、术后1、12、24、48 h,两组静息状态下的VAS评分无明显差异(P>0.05)。术后4、8、12周,两组的髋关节活动度均高于术前,且研究组高于对照组(P<0.05)。两组的不良反应总发生率无明显差异(P>0.05)。结论关节腔注射药物对全髋关节置换术后老年患者的镇痛效果优于髂筋膜阻滞镇痛。

Objective To compare the application effect of intra-articular injection of drugs and iliac fascia block in analgesia after total hip arthroplasty.Methods A total of 95 elderly patients who underwent total hip arthroplasty in our hospital from May 2020 to May 2022 were selected as the research objects.According to different analgesic methods,the elderly patients were divided into control group(48 cases)and study group(47 cases).The control group underwent iliac fascia block analgesia,and the study group underwent intra-articular injection of drugs for analgesia.The analgesic effects of the two groups were compared.Results After operation,the levels of cortisol(Cor),epinephrine(E)and norepinephrine(NE)in the two groups were higher than those before operation,but those in the study group were lower than the control group(P<0.05).At 1,12,24 and 48 h after operation,the scores of Visual Analogue Scale(VAS)in resting state and motion state of the two groups were lower than those before operation,and the VAS score in motion state of the study group was lower than that of the control group(P<0.05);there was no significant difference in VAS score in resting state between the two groups before operation and at 1,12,24 and 48 h after operation(P>0.05).At 4,8 and 12 weeks after operation,the hip joint activity of the two groups was higher than that before operation,and that of the study group was higher than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The analgesic effect of intra-articular injection of drugs in elderly patients after total hip arthroplasty is better than that of iliac fascia block analgesia.