不同镇痛方式对TKA患者镇痛效果及血栓发生风险的影响探究  

Analgesic effect of different analgesia methods on patients with TKA and its influence on incidence of thrombosis

作　　者：黄俊霞[1] 代彭威[2] 赵梅珍[1] 张秀珍[1] 刘晓伟[1] 陈辉[1] 朱建业 HUANG Jun-xia.(Department of anesthesiology, the second affiliated hospital of Luohe Medical College, Luohe Henan, 463200, China)

机构地区：[1]漯河医学高等专科学校第二附属医院麻醉科,河南463200 [2]漯河医学高等专科学校第二附属医院骨科,河南463200

出　　处：《齐齐哈尔医学院学报》2017年第24期2862-2865,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨连续股神经阻滞与镇痛泵对全膝关节置换术(TKA)患者术后镇痛效果及安全性差异。方法选取2014年2月至2015年2月于我院行TKA的98例老年患者为研究对象,采用随机数字表法将其分成研究组(A组,n=49)和对照组(B组,n=49)两组。B组术后予以持续静脉镇痛方案,A组予以腰硬联合麻醉后超声引导下连续股神经阻滞镇痛方案。比对两组患者术后12 h、24 h、48 h等时段内镇痛效果差异,记录其不良反应发生率及术后一周内下肢深静脉血栓发生率差异。结果 (1)A组患者术后12 h、24 h、48 h等时段内镇痛有效率均显著高于B组,差异具有统计学意义(P<0.05);(2)A组镇痛治疗后不良反应发生率为6.1%,显著低于B组的20.4%,差异具有统计学意义(P<0.05);A、B两组患者术后并发下肢深静脉血栓的几率分别为10.2%和12.2%,对比差异无统计学意义(P>0.05)。麻醉后超声引导下持续股神经阻滞镇痛方案用于TKA老年患者的临床治疗中,镇痛效果确切,且安全性结论将腰硬联合突出,于患者预后恢复有利。Objective To investigate the analgesic effect and safety of continuous femoral nerve block and analgesia pump in patients with total knee arthroplasty（ TKA）. Methods From Feb. 2014 to Feb. 2015,a total of 98 elderly patients with TKA in our hospital were taken as the clinical research objects,and they were randomly divided into study group（ A group,n = 49） and control group（ B group,n = 49）. Group B was given continuous intravenous analgesia after surgery,and A group was given ultrasound-guided continuous femoral nerve block analgesia program after combined spinal epidural anesthesia. The analgesic effects after 12 h,24 h and 48 h in the two groups were compared,and the adverse reaction rates and the incidence rates of lower extremity deep vein thrombolysis within one week after operation in the two groups were also recorded and compared. Results The analgesic effects at 12 h,24 h and 48 h after surgery in the A group were obviously higher than those in the B group,and their differences were statistically significant（ P〈0.05）. The adverse reaction rate in the A group was6.1% which was obviously lower than 20.4% in the B group,and their difference was statistically significant（ P〈0.05）. The incidence rates of lower extremity deep vein thrombolysis in the A and B group were respectively10.2% and 12. 2%,and there was no significant difference between the two group（ P 〉0. 05）. Conclusions Ultrasound-guided continuous femoral nerve block analgesia program after combined spinal epidural anesthesia which has good analgesic effect and outstanding safety for elderly patients with TKA,it is conducive to patients＇ prognostic recovery.

关 键 词：连续股神经阻滞 镇痛泵 全膝关节置换术 术后镇痛效果 安全性 

分 类 号：R971.2[医药卫生—药品]