本文關鍵詞： 假體植入 關節(jié)成形術 置換 膝 股神經(jīng) 鎮(zhèn)痛 組織工程 骨科植入物 人工假體 加巴噴丁 連續(xù)股神經(jīng)阻滯 全膝關節(jié)置換 圍手術期 鎮(zhèn)痛效果 生活質量 膝關節(jié)活動度　出處：《中國組織工程研究》2015年44期 　論文類型：期刊論文

【摘要】：背景:傳統(tǒng)的鎮(zhèn)痛方法雖然能夠緩解全膝關節(jié)置換患者疼痛,但是預后較差,藥物依賴性較強。因此,臨床上研究全膝關節(jié)置換圍手術期鎮(zhèn)痛藥物具有重要的意義。目的:探討加巴噴丁聯(lián)合連續(xù)股神經(jīng)阻滯對于全膝關節(jié)置換的鎮(zhèn)痛效果。方法:從內蒙古醫(yī)科大學附屬醫(yī)院骨科2013年10月至2014年10月收治的因膝關節(jié)骨關節(jié)炎行全膝關節(jié)置換的48例患者進行研究,均采用全身麻醉方式,且麻醉前行股神經(jīng)阻滯,置換后連接鎮(zhèn)痛泵。按照隨機數(shù)字表法將患者分為兩組,對照組采用多模式鎮(zhèn)痛,試驗組采用加巴噴丁聯(lián)合連續(xù)股神經(jīng)阻滯鎮(zhèn)痛。采用靜息、活動目測類比評分對患者疼痛程度進行評分,觀察患者置換后生活質量、膝關節(jié)活動度及并發(fā)癥等相關指標。結果與結論:兩組置換前靜息痛和活動痛差異無顯著性意義(P0.05);兩組置換后疼痛隨著時間延長目測類比評分降低,試驗組置換后1,3,7 d以及1個月靜息痛和活動痛目測類比評分均顯著低于對照組(P0.05)。試驗組置換后3-7 d膝關節(jié)活動度均顯著大于對照組,差異有顯著性意義(P0.05)。隨訪12個月,試驗組日常生活能力量表(ADL)評分、軀體功能評分、心理功能評分及社會功能評分均顯著高于對照組(P0.05)。試驗組并發(fā)癥發(fā)生率顯著低于對照組(17%,46%,P0.05)。提示在全膝關節(jié)置換圍手術期實施加巴噴丁聯(lián)合連續(xù)股神經(jīng)阻滯鎮(zhèn)痛效果理想,尤其是48 h內急性疼痛者,能夠促進患者膝關節(jié)功能早期恢復,且不良反應少。
[Abstract]:Background: although traditional analgesic methods can relieve pain in patients with total knee arthroplasty, the prognosis is poor and drug dependence is strong. It is important to study the analgesic drugs in perioperative period of total knee arthroplasty. Objective: to study the analgesic effect of gabapentin combined with continuous femoral nerve block on total knee arthroplasty. Methods: from Inner Mongolia Medical University. From October 2013 to October 2014, 48 patients with knee osteoarthritis underwent total knee arthroplasty. The patients were divided into two groups according to the method of random number table, the control group was treated with multi-mode analgesia, and the patients in the control group were treated with multi-mode analgesia. The experimental group was treated with gabapentin combined with continuous femoral nerve block analgesia. The patients' pain degree was evaluated by resting and visual analogue score, and the quality of life was observed after replacement. Results and conclusion: there was no significant difference in resting pain and active pain between the two groups before replacement (P 0.05). The visual analogue scores of resting pain and active pain in the trial group were significantly lower than those in the control group at 1: 3 ~ 7 days and 1 month after replacement. The knee joint motion in the trial group was significantly higher than that in the control group at 3 to 7 days after replacement, and there was a significant difference between the two groups. 12 months follow-up showed that the knee joint motion in the trial group was significantly higher than that in the control group. ADL score and somatic function score in the test group; The scores of psychological function and social function were significantly higher than those of the control group (P 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P 0.05). It suggested that the analgesic effect of gabapentin combined with continuous femoral nerve block during the perioperative period of total knee arthroplasty was ideal. Especially in patients with acute pain within 48 hours, the early recovery of knee joint function was promoted, and the adverse reactions were less.
【作者單位】： 內蒙古醫(yī)科大學附屬醫(yī)院麻醉科;內蒙古醫(yī)科大學附屬醫(yī)院骨科;
【基金】：內蒙古醫(yī)科大學青年創(chuàng)新基金項目(YKD2012QNCX017)~~
【分類號】：R614

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本文編號：1510681