本文關鍵詞： 肩袖縫合 羅哌卡因 術后疼痛 中國人肩關節(jié)功能評分表　出處：《皖南醫(yī)學院》2017年碩士論文　論文類型：學位論文

【摘要】：目的:觀察肩關節(jié)鏡下肩袖縫合術后局部注射羅哌卡因對病人術后疼痛的影響。方法:選取我科室2015年10月—2017年03月期間行肩關節(jié)鏡治療的肩袖損傷的患者32例,按照數字表法隨機的將其分為觀察組和對照組各16例。觀察組在肩關節(jié)鏡下縫合肩袖后于盂肱關節(jié)或肩峰下間隙注射10ml羅哌卡因注射液,對照組僅注射10ml生理鹽水。術后應用視覺模擬疼痛評分(VAS)和中國人肩關節(jié)功能評分表來觀察患者的疼痛和肩關節(jié)功能恢復情況,同時記錄兩組患者不良反應發(fā)生率。結果:(1)兩組患者術后24小時左右疼痛達高峰,觀察組和對照組VAS評分分別為(3.3±0.8)分和(4.5±0.7)分,48小時內局部注射羅哌卡因的觀察組患者其疼痛程度明顯低于未局部用藥的對照組患者,差異有統(tǒng)計學意義;72h后兩組患者靜息痛明顯緩解,疼痛VAS評分全都在5分以下差異無統(tǒng)計學意義。(2)觀察組患者術后24h和2d活動時疼痛VAS評分分別為(4.2±0.8)分、(5.0±0.9)分低于對照組的(5.2±0.9)分、(5.9±0.7)分,差異有統(tǒng)計學意義;但3d之后兩組患者活動時疼痛程度無統(tǒng)計學差異。(3)兩組患者術后肩關節(jié)功能均較術前有明顯提高,且兩組患者之間肩關節(jié)功能恢復情況無明顯差異,P0.05,差異無統(tǒng)計學意義。(4)兩組患者術后均未發(fā)生嚴重不良反應,最常見的就是惡心嘔吐,且兩組不良反應發(fā)生率無明顯差異,P0.05,無統(tǒng)計學意義。結論:肩關節(jié)鏡下肩袖縫合術后局部注射羅哌卡因確實能減輕患者術后早期的疼痛,尤其能減輕活動時的疼痛,且未見明顯不良反應和影響患者肩關節(jié)功能恢復,是一種簡單、安全、有效和方便的止痛方案,值得在臨床上推廣使用。
[Abstract]:Objective: to observe the effect of local injection of ropivacaine on postoperative pain after arthroscopic rotator cuff suture. Methods: 32 patients with rotator cuff injury treated by arthroscopy from October 2015 to March 2017 in our department were selected. According to the method of digital table, it was randomly divided into observation group (n = 16) and control group (n = 16). In observation group, 10ml ropivacaine injection was injected into glenohumeral joint or subacromial space after the cuff was sutured under shoulder arthroscopy. The control group was only injected with 10 ml saline. Visual analogue pain score (VAS) and Chinese shoulder function scale were used to observe the pain and the recovery of shoulder function. At the same time, the incidence of adverse reactions in both groups was recorded. Results the pain peaked 24 hours after operation in both groups. The VAS scores of the observation group and the control group were 3.3 鹵0.8 and 4.5 鹵0.7, respectively. The pain degree of the observation group with ropivacaine injection was significantly lower than that of the control group. The difference was statistically significant after 72 hours. There was no significant difference in pain VAS score below 5 (P < 0.05). The VAS score of pain in the observation group was 4.2 鹵0.8 at 24 hours and 2 days after operation. The score was 5.0 鹵0.9), which was lower than that in the control group (5.2 鹵0.9) and 5.9 鹵0.7, respectively, and the difference was statistically significant. However, there was no significant difference in the degree of pain between the two groups after 3 days.) the function of the shoulder joint in the two groups was significantly higher than that before operation. There was no significant difference in the recovery of shoulder joint function between the two groups (P 0.05, P 0.05, no significant difference.) there was no serious adverse reaction after operation in both groups, and the most common was nausea and vomiting. There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: the local injection of ropivacaine after shoulder arthroscopic rotator cuff suture can alleviate the early postoperative pain, especially the pain during exercise. It is a simple, safe, effective and convenient analgesic scheme, which is worth popularizing in clinic.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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