“鸡尾酒”疗法在全髋关节置换术后的疗效评价  

Evaluation about Curative effect of Intraarticular Cocktail after Total Hip Arthroplasty

作　　者：刘辉亮[1] 黄敏强[1] 丁焕文[1] 苗秋菊[1] 

机构地区：[1]中国人民解放军广州总医院骨科,广东广州510010

出　　处：《赣南医学院学报》2017年第4期527-531,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探索全髋关节置换术中使用"鸡尾酒"疗法术后镇痛的临床效果。方法:将2011年1月至2015年5月在我院骨科住院的43例行单侧全髋关节置换术的患者,随机分成两组,试验组22例,术中行"鸡尾酒"混合剂(氨甲环酸、帕瑞昔布、曲安奈德、庆大霉素、肾上腺素)注射;对照组21例,术中注射等量生理盐水,比较两组患者全髋关节置换术后静息和活动视觉模拟评分、Harris评分优良率,术后并发症发生情况及出血量情况。结果:两组术后12 h、24 h、48 h、3 d、7 d静息痛评分试验组显著小于对照组(P<0.05)。两组术后12 h、24 h、48 h、3 d、7 d活动痛评分试验组显著少于对照组(P<0.05);在Harris评分上,试验组优于对照组,差异有统计学意义(P<0.05);术后并发症,两组无明显差异。术后出血量,试验组少于对照组,差异性显著(P<0.05)。结论:全髋关节置换术中使用"鸡尾酒"疗法,能有效减轻患者术后早期疼痛和出血量,有助于患者早期康复,安全有效。Objective: To observe the analgesia clinical effect of intraarticular cocktail after total hip arthroplasty. Methods: A total of 43 patients underwent total hip arthroplasty were randomly assigned to the test group( intraarticular cocktail analgesic injection with tranexamic acid,parecoxib injection,and triamcinolone acetonide,gentamicin,epinephrine),and the control group( intravenous injection of normal saline) in our hospital from January 2011 to May 2015.Analgesic consumption,visual analog scale at rest and during activity,good rate of Harris score,postoperative complication and postoperative blood loss of the two groups were compared. Results: When comparing visual analog scale scores,rest pain scores were significantly less in test group at 12 h,24 h,48 h,3 d and 7 d after replacement than that in the control group( P < 0. 05). Scores on range of motion were significantly less in the test group at 12 h,24 h,48 h,3 d and 7 d than that in the control group( P < 0. 05). After treatment,the Harris score of test group was higher than that in the control group; there was obvious difference( P < 0. 05). No significant differences in total complications were detectable in two groups( P > 0. 05). postoperative bleeding volume in test group was obviously lower than that in control group( P < 0. 05). Conclusion: Using the ' cocktail' therapy in total hip arthroplasty can effectively reduce postoperative pain and early bleeding and contribute to the early rehabilitation of patients,safe and effective.

关 键 词：“鸡尾酒”疗法 全髋关节置换 疗效 

分 类 号：R687.4[医药卫生—骨科学]