连续股神经阻滞联合坐骨神经阻滞镇痛在膝关节置换术后康复训练中的应用初探  

Application of combined continuous analgesia for femoral and sciatic nerve blocks in the rehabilitation process after total knee arthroplasty

作　　者：彭建光[1] 沈惠良[1] 曹光磊[1] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《中国现代医学杂志》2013年第31期67-69,共3页China Journal of Modern Medicine

摘　　要：目的探讨在全膝关节置换术后康复训练中连续股神经阻滞联合坐骨神经阻滞镇痛的影响。方法选取2010年10月~2012年4月在该科接受单侧初次全膝关节置换手术的患者40人,随机分为连续股神经阻滞镇痛（CFNB）组和连续股神经阻滞联合坐骨神经阻滞镇痛（CFSNB）组,每组20例。两组采用相同的手术技术和康复训练方法。记录术后第1、2天康复训练前后的疼痛评分,即静息疼痛评分和活动疼痛评分;术后第2、7天康复训练结束后膝关节的活动度。结果 CFSNB组的疼痛评分在静息和活动情况下均比CFNB组显著低（P〈0.01）。膝关节活动度,术后第2天CFSNB组与CFNB组比较角度显著大（P〈0.01）,术后第7天两组角度差异无显著性（P=0.18）。结论全膝关节置换术后早期,连续股神经阻滞联合坐骨神经阻滞镇痛可提供满意的镇痛效果进行康复训练。【Objective】To discuss the influence of continuous femoral and sciatic nerve blocks on rehabilitation process after total knee arthroplasty.【Methods】40 patients firstlyunderwent unilateral TKA surgery from Oct. 2010 to Apr. 2012 were randomly divided into the group of continuous analgesia for femoral nerve block and the group of combined continuous analgesia for femoral and sciatic nerve blocks. Each group included 20 patients. All patients received the same operative technique and rehabilitation strategy. On the first and second day after the surgery, vi- sual analogue scale（VAS） scores such as pain scores at rest and activity pain scores were assessed before and during rehabilitation. On the second and seventh day, a range ofknee motion（ROM） after rehabilitation were recorded. 【Results】VAS scores in the group of combined continuous analgesia for femoral and sciatic nerve blocks at rest and during rehabilitationwas obvious lower than the group of continuous analgesia for femoral nerve block（P 0.01）. ROM in the group of combined continuous analgesia for femoral and sciatic nerve blocks was significantly improved than the group of continuous analgesia for femoral nerve block on the second day postoperatively（P 0.01）. On the seventh day, no significant difference of motion range existed（P =0.18）.【Conclusions】After TKA, combined con- tinuous analgesia for femoral and sciatic nerve blocks provides satisfactory effect to facilitate rehabilitation.

关 键 词：全膝关节置换 股神经阻滞 坐骨神经阻滞 术后镇痛 康复 

分 类 号：R687.42[医药卫生—骨科学]