多模式镇痛在人工全膝关节置换术后患者中的应用效果  

The Effect of Multimodal Analgesia on Patients after Total Knee Replacement

作　　者：严素敏[1] 冯宗权[1] 廖荣宗[1] 余建华[1] 潘耀成 梁少红[1] Yan Sumin;Feng Zongquan;Liao Rongzong(Foshan Hospital of TCM,Foshan Guangdong 528000,China)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《齐鲁护理杂志》2018年第24期15-18,共4页Journal of Qilu Nursing

基　　金：2013年佛山市医学类科技攻关项目(编号:201308033)

摘　　要：目的:探讨多模式镇痛在人工全膝关节置换术后患者中的应用效果。方法:将240例人工全膝关节置换术后患者随机分为观察组和对照组各120例,观察组应用无痛病房管理模式的多模式镇痛方案,对照组术后视具体情况进行镇痛干预。采用视觉模拟评分法(VAS)评定患者疼痛程度,采用膝关节关节活动度(ROM)评定患者主动屈膝度;术后2周,采用酶联免疫吸附测定法(ELISA)评定患者血浆C反应蛋白(CRP)、白介素-6(IL-6)表达水平,HSS膝关节评分评估患者膝关节功能,采用生活质量综合评定问卷(GQOLI-74)评估患者生活质量。结果:观察组患者术后12、24、48 h VAS评分均低于对照组(P <0. 05)、ROM大于对照组(P <0. 05);术后2周,观察组患者血浆CRP、IL-6表达水平均低于对照组(P <0. 05),疼痛、功能、活动度等维度HSS评分以及HSS总分均高于对照组(P <0. 05),躯体健康、心理健康、社会功能等维度GQOLI-74评分以及GQOLI-74总分均高于对照组(P <0. 05)。结论:多模式镇痛可有效缓解人工全膝关节置换术后患者疼痛情况、降低应激反应,促进膝关节功能康复,提升患者生活质量。Objective: To investigate the effect of multimodal analgesia in patients after total knee replacement. Methods: A total of 240 patients with total knee replacement were randomly divided into the observation group and the control group with 120 cases each. The observation group was treated with the multimodal analgesia scheme of painless ward management mode,and the control group was treated with analgesia intervention according to the specific situation after the operation. Visual analogue scales( VAS) was used to evaluate the pain level of patients,and knee joint range of motion( ROM) was used to evaluate the degree of active knee flexion. Two weeks after surgery,the levels of plasma c-reactive protein( CRP) and interleukin-6( Il-6) were assessed by ELISA. Knee function was assessed by HSS score,and the quality of life was assessed by GQOLI-74. Results: VAS scores at 12,24 and 48 h after surgery in the observation group were lower than those in the control group( P < 0. 05),and ROM was higher than those in the control group( P < 0. 05). Two weeks after surgery,the plasma CRP and IL-6 expression levels in the observation group were lower than those in the control group( P < 0. 05). The HSS scores and total HSS scores in the dimensions of pain,function and activity were higher than those in the control group( P < 0. 05). And the GQOLI-74 scores and total GQOLI-74 scores in the dimensions of physical health,mental health and social function were higher than those in the control group( P < 0. 05). Conclusion: Multimodal analgesia can effectively relieve the pain of patients after total knee replacement,reduce the stress response,promote the rehabilitation of knee joint function,and improve the quality of life of patients.

关 键 词：多模式镇痛 全膝关节置换术 疼痛阈值 应激反应 功能康复 

分 类 号：R473.6[医药卫生—护理学]