發(fā)布時(shí)間：2018-06-07 05:51

  本文選題：組織工程 + 膝關(guān)節(jié)　； 參考：《中國(guó)組織工程研究》2015年39期

【摘要】：背景:積極的人工全膝關(guān)節(jié)置換極大改善了膝關(guān)節(jié)退行性疾病患者的生活質(zhì)量,但圍置換期急性疼痛廣泛存在,增加了并發(fā)癥的發(fā)生概率,阻礙了患者的康復(fù)鍛煉,因此圍置換期疼痛處理成為當(dāng)前膝關(guān)節(jié)置換的重要課題。目的:觀察比較包括帕瑞昔布鈉超前鎮(zhèn)痛、關(guān)節(jié)周圍鎮(zhèn)痛、帕瑞昔布鈉超前鎮(zhèn)痛與關(guān)節(jié)周圍鎮(zhèn)痛聯(lián)合等方案在患者膝關(guān)節(jié)置換后鎮(zhèn)痛中的療效及安全性,探索合理有效的鎮(zhèn)痛方案。方法:隨機(jī)選擇江蘇省徐州市中心醫(yī)院在2012年5月至2014年12月收治的60例膝關(guān)節(jié)置換患者,通過(guò)隨機(jī)數(shù)表法將其分為帕瑞昔布鈉超前鎮(zhèn)痛組、關(guān)節(jié)周圍鎮(zhèn)痛組、帕瑞昔布鈉超前鎮(zhèn)痛+關(guān)節(jié)周圍鎮(zhèn)痛組、空白對(duì)照組,每組15例,在膝關(guān)節(jié)置換中對(duì)患者實(shí)施不同的鎮(zhèn)痛方案。結(jié)果與結(jié)論:置換后6,12,24,36 h,與其他3組比較,帕瑞昔布鈉超前鎮(zhèn)痛+關(guān)節(jié)周圍鎮(zhèn)痛組各時(shí)間段的靜息痛、活動(dòng)痛疼痛評(píng)分及鎮(zhèn)痛藥物用量均顯著降低(P0.05),置換后麻醉劑的使用時(shí)間間隔明顯長(zhǎng)于其他3組(P0.05)。置換后3 d,與其他3組比較,內(nèi)帕瑞昔布鈉超前鎮(zhèn)痛+關(guān)節(jié)周圍鎮(zhèn)痛組患者置換后的主動(dòng)抬腿時(shí)間、主動(dòng)屈膝90°時(shí)間顯著縮短(P0.05),而膝關(guān)節(jié)活動(dòng)度較好。帕瑞昔布鈉超前鎮(zhèn)痛+關(guān)節(jié)周圍鎮(zhèn)痛組患者在3組中不良反應(yīng)發(fā)生率最低(P0.05)。結(jié)果提示帕瑞昔布鈉聯(lián)合關(guān)節(jié)周圍鎮(zhèn)痛是一種安全可行的鎮(zhèn)痛方案,能顯著減少膝關(guān)節(jié)置換后疼痛,減少麻醉用量,患者置換后不良反應(yīng)降低,有助于改善患者的關(guān)節(jié)活動(dòng)度并促進(jìn)患者早期康復(fù)。
[Abstract]:Background: active total knee arthroplasty greatly improves the quality of life of patients with knee joint degenerative diseases, but acute pain is widespread in peri-replacement period, which increases the probability of complications and hinders the rehabilitation of patients. Therefore, perioperative pain management has become an important issue in knee arthroplasty. Objective: to compare the efficacy and safety of preemptive analgesia with paroxib sodium, periarticular analgesia, preemptive analgesia with paroxib sodium and periarticular analgesia in patients with knee arthroplasty. To explore a reasonable and effective analgesic scheme. Methods: sixty patients with knee replacement were randomly selected from Xuzhou Central Hospital of Jiangsu Province from May 2012 to December 2014. The patients were randomly divided into two groups: paroxib sodium preemptive analgesia group and periarticular analgesia group. The periarticular analgesia group (n = 15) and control group (n = 15) were treated with different analgesic schemes during knee arthroplasty. Results and conclusion: compared with the other three groups, preemptive analgesia of pericyclob sodium was performed in the periarticular analgesia group at every time period. The scores of active pain and the dosage of analgesic drugs were significantly lower than those of the other three groups. The time interval of anesthetic use after replacement was significantly longer than that of the other three groups. 3 days after replacement, compared with the other three groups, the time of active leg lift and 90 擄flexion of patients with periarticular analgesia after replacement were significantly shortened and the range of knee motion was better than that of the other three groups. Paroxib sodium preemptive analgesia group had the lowest incidence of adverse reactions in the three groups. The results suggest that paroxib sodium combined with periarticular analgesia is a safe and feasible analgesic scheme, which can significantly reduce pain after knee arthroplasty, reduce the amount of anesthesia, and decrease the adverse reactions after replacement. It is helpful to improve the patient's joint motion and promote the patient's early recovery.
【作者單位】： 江蘇省徐州市中心醫(yī)院麻醉科;
【分類號(hào)】：R614

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本文編號(hào)：1990076