股神经阻滞镇痛对全膝关节置换术后早期功能的影响  

Influence of femoral nerve block analgesia on early joint function recovery after total knee arthroplasty

作　　者：臧学慧[1] 孙辉[1] 高立华[1] 苗贵强[1] 林军[1] 

机构地区：[1]南方医科大学附属南海医院骨科,广东佛山528200

出　　处：《中华关节外科杂志（电子版）》2016年第2期26-29,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：佛山市医学类科技攻关项目(2014AB000332)

摘　　要：目的评价股神经阻滞镇痛对全膝关节置换术(TKA)后早期功能的影响。方法选取2014年1月至2014年12月在南方医科大学附属南海医院骨科因膝关节骨关节炎行单侧TKA患者80例,随机分为常规镇痛组(C组)和股神经阻滞泵镇痛组(F组),观察术后疼痛程度、美国特种外科医院(HSS)膝关节评分情况及术后再住院率。结果 2组所有患者均未发生感染、深静脉血栓等并发症。2组患者术毕及术后第1、2、3天静息疼痛评分相似,差异无统计学意义(P>0.05),而F组被动屈膝在各个时间点上疼痛评分较低,差异有统计学意义(P<0.05)。所有患者术后6个月HSS评分较术前明显提高,差异具有统计学意义(P<0.05);F组较C组在术后1个月HSS评分明显增高,比较差异显著(P<0.05);F组与C组术后3、6个月HSS评分相近,无统计学意义(P>0.05);术后6个月内再住院率比较,F组显著低于C组(P<0.05)。结论 TKA后采用股神经阻滞泵镇痛,镇痛效果良好,促进膝关节功能早期恢复,缩短康复期,减轻后期功能训练带来的痛苦。Objective To evaluate the effect of femoral nerve block on the early stage knee function after total knee arthroplasty. Methods Eighty patients received total knee arthroplasty surgery from January 2014 to December 2014 were randomly divided into common analgesia group（ group C） and femoral nerve block analgesia group（ group F）. Pain degree,hospital for special surgery（ HSS） knee score and rehospitalization rate were compared between the two groups. Results No infection,severe deep vein thrombosis and other complications occured in either group. In the first three days after the surgery,rest pain scores showed no difference between group C and F（ P〈 0. 05）,but group F presented lower passive motion pain scores（ P〈 0. 05）. HSS scores of all the patient increased six months after the surgery. Group F had better HSS scores in the first month after the surgery（ P〈 0. 05）,but showed no significant difference compared with group C in the third and sixth months after the surgery（ P〈 0. 05）.Group F also had a lower rehospitalization rate six months after the surgery（ P〈 0. 05）. Conclusion Femoral nerve block shows a good antalgic effect,and can advance the knee function recovery process in early stage after the surgery,which will shorten the rehabilitation period and relieve the pain caused by function excise in the later stage after the surgery.

关 键 词：关节成形术 置换 膝 股神经病 镇痛 

分 类 号：R687.4[医药卫生—骨科学]