【摘要】：目的:探討多模式超前鎮(zhèn)痛在人工關(guān)節(jié)置換術(shù)后疼痛治療中的療效方法:選取2014年06月至2014年10月于山東省中醫(yī)院關(guān)節(jié)骨科行關(guān)節(jié)置換術(shù)18~80歲患者共70人,按入院日期先后順序?qū)⒒颊咭来尉幪?根據(jù)編號次序分為兩個組,次序是奇數(shù)號的患者歸為實驗組,次序是偶數(shù)號的患者為對照組。經(jīng)過篩選,實驗組剩余33人,對照組剩余32人,實驗組術(shù)前12h給予400mg口服,術(shù)后前三天給予塞來昔布200mg Bid,同時應(yīng)用自控鎮(zhèn)痛泵至藥物用完,而對照組術(shù)前不給予鎮(zhèn)痛藥物,對照組術(shù)后只采用自控鎮(zhèn)痛泵至藥物用完,不再應(yīng)用其他鎮(zhèn)痛藥物。觀察兩組患者基本情況,并進行VAS評分,以及患者是否有藥物不良反應(yīng)發(fā)生,統(tǒng)計資料,進行比較。結(jié)果:術(shù)后前三天兩組的VAS評分,實驗組明顯低于對照組,實驗組與對照組在術(shù)后第1天、第2天、第3天VAS評分有顯著性的差異(P0.05);實驗組總體不良反應(yīng)發(fā)生率略低于對照組,然而兩組在不良反應(yīng)方面不具有顯著性差異(P0.05)。結(jié)論:在人工關(guān)節(jié)置換術(shù)中,多模式超前鎮(zhèn)痛具有很好的鎮(zhèn)痛效果,可以有效的減輕手術(shù)患者圍手術(shù)期的疼痛,而鎮(zhèn)痛藥物所帶來的不良反應(yīng),也有減少的趨勢,提高了患者對鎮(zhèn)痛及手術(shù)的滿意度,有利于患者的術(shù)后功能恢復(fù),然而在超前鎮(zhèn)痛的時機,以及鎮(zhèn)痛藥物的劑量方面,需要進一步的探討。
[Abstract]:Objective: to investigate the efficacy of multimode preemptive analgesia in the treatment of postoperative pain after arthroplasty: 70 patients aged 1880 years were selected from June 2014 to October 2014 in the Department of Orthopaedics of Shandong traditional Chinese Medicine Hospital. The patients were divided into two groups according to the serial number. The patients with odd number were classified as the experimental group and the patients with even number were the control group. After screening, 33 patients in the experimental group and 32 patients in the control group were given 400mg orally at 12 hours before operation, and celecoxib 200mg Bid, was given to the patients at the same time until the drug was used up three days before the operation, while the control group was not given the analgesic drugs before operation. In the control group, only the patient controlled analgesia pump was used up and no other analgesic was used. To observe the basic situation of the two groups, and to evaluate the VAS score, and whether there were adverse drug reactions, statistical data were compared. Results: the VAS scores of the two groups in the first three days after operation were significantly lower in the experimental group than in the control group. There was a significant difference in the VAS score between the experimental group and the control group on the 1st, 2nd and 3rd day after operation (P0.05), and the overall adverse reaction rate in the experimental group was slightly lower than that in the control group. However, there was no significant difference in adverse reactions between the two groups (P0.05). Conclusion: Multi-mode preemptive analgesia has a good analgesic effect during artificial joint replacement, which can effectively alleviate the perioperative pain of patients, and the adverse reactions caused by analgesic drugs are also decreasing. It can improve the patients' satisfaction with analgesia and surgery, which is beneficial to the recovery of postoperative function. However, the timing of preemptive analgesia and the dosage of analgesic drugs need to be further explored.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.4

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