超声引导下连续股神经阻滞在全膝关节置换术术后镇痛中的应用  

作　　者：杨世忠[1] 杜津[1] 

机构地区：[1]武警浙江省总队嘉兴医院,314000

出　　处：《浙江临床医学》2018年第4期750-751,共2页Zhejiang Clinical Medical Journal

摘　　要：目的比较超声引导下连续股神经阻滞（CFNB）与患者自控静脉镇痛（PCIA）在全膝关节置换术（TKA）术后镇痛的效果、下地锻炼时间、并发症等方面的差异。方法选取择期行TKA术的患者共80例，将其分为连续股神经阻滞组（CFNB组）和静脉镇痛组（PCIA组），每组各40例，分别使用CFNB和PCIA进行术后镇痛。记录两组患者术后各个时间点的疼痛评分、最早在床及下床锻炼时间和每日锻炼总时间、术后辅助止痛药物用量以及并发症。结果CFNB组术后静息痛、运动痛的疼痛评分均低于PCIA组，差异有统计学意义（P〈0．05或P〈0．01）。CFNB组术后最早在床锻炼时间及下床锻炼时间均早于PCIA组，术后两日每日锻炼总时间大于PCIA组，差异有统计学意义（P〈0．05或P〈0．01）。两组并发症发生率无明显差异（P〉0．05）。结论在TKA术后，超声引导下CFNB镇痛比PCIA镇痛效果优秀，更有利于患者早期康复锻炼，无额外并发症发生。Objective To compare the differences between ultrasound-guided continuous femoral nerve block （ CFNB ） and patient-controlled intravenous analgesia （ PCIA ） after total knee arthroplasty （ TKA ） in postoperative analgesia, exercise time and complications. Methods 80 patients underwent total knee arthroplasty were randomly divided into two groups： group CFNB and group PCIA. The VAS pain score, the earliest in the bed and bed time and total daily exercise time postoperative analgesic dmgs dosage and complications in the two groups of patients after each time point were recorded. Results The VAS scores of rest pain and movement pain in CFNB group were lower than those in group PCIA, the difference was statistically significant （ P〈0.05 or P〈0.01 ） . The initial time of bed exercise and the time of getting out of bed in the CFNB group were earlier than those in the PCIA group, and the daily exercise time was greater than that of the PCIA group two days after the operation, and the difference was statistically significant （ P〈0.05 or P〈0.01 ） . There was no significant difference in the incidence of complications between the two groups （ P〉0.05 ） . Conclusion After TKA, ultrasound-guided CFNB has better analgesic effect than PCIA, which is more favorable for early rehabilitation exercise, and no additional complications occur

关 键 词：超声引导 连续股神经阻滞 自控静脉镇痛 全膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]