鸡尾酒式镇痛复合液对髋部骨折手术后认知功能及髋关节功能恢复的影响  

Effects of “cocktail” compound injection on cognitive function and hip function recovery after hip fracture surgery

作　　者：赵蕾 李桂明 马璋辉 张国良 吴彤 郭峰 ZHAO Lei;LI Guiming;MA Zhanghui(Department of Surgery,People’s Hospital of Wuqiao County,Hebei,Wuqiao 061800,China)

机构地区：[1]河北省吴桥县人民医院外科

出　　处：《河北医药》2019年第11期1699-1702,共4页Hebei Medical Journal

基　　金：沧州市重点研发计划指导项目(编号:172302091)

摘　　要：目的研究鸡尾酒式镇痛复合液对髋部骨折手术后认知功能及髋关节功能恢复的影响。方法选择2017年12月至2018年12月收治的髋部骨折手术患者60例,入院后按照数字表法随机分为研究组和对照组。研究组术中注射鸡尾酒式镇痛复合液,对照组术中注射0.9%氯化钠溶液,比较2组术后6 h、12 h、24 h、48 h平卧时,被动抬高大腿15°时静息及运动VAS评分、谵妄、其他相关并发症发生情况,术后7 d、14 d髋关节主动屈曲外展活动度及术后1个月、3个月、6个月髋关节功能恢复情况,日常生活活动能力。结果研究组术后6 h、12 h、24 h、48 h静息VAS评分、运动VAS评分低于对照组,差异有统计学意义(P<0.05)。2组术前MoCA评分比较差异无统计学意义(P>0.05),2组术后MoCA评分均明显低于术前,差异有统计学意义(P<0.05),且研究组术后MoCA评分低于对照组(P<0.05)。研究组术后谵妄、恶心呕吐、眩晕发生率低于对照组,差异有统计学意义(P<0.05),嗜睡、皮肤瘙痒、尿潴留发生率比较差异无统计学意义(P>0.05)。研究组术后7 d、14 d髋关节屈曲活动度和髋关节外展活动度及术后1个月、3个月、6个月Harris髋关节功能评分、Barthel评分高于对照组,差异有统计学意义(P<0.05)。结论髋部骨折患者术中注射鸡尾酒式镇痛复合液能够有效缓解骨折疼痛程度,促进术后认知功能和髋关节功能恢复,提高日常生活活动能力,且并发症发生率低。Objective To investigate the effects of "cocktail" compound injection on cognitive function and hip function recovery after hip fracture surgery.Methods Sixty patients who were admitted into our hospital and underwent hip fracture surgery from December 2017 to December 2018 were enrolled in this study. After admission, these patients were randomly divided into research group and control group according to the digital table method.The patients in research group were injected with "cocktail" compound injection, however,the patients in control group were injected with 0.9% sodium chloride solution. Resting and active VAS scores for passive leg raising(15 degrees) when they were kept in supine position at 6 h, 12 h, 24 h, and 48 h after operation were observed and compared between the two groups,moreover, the delirium and other related complications were recorded. In addition the hip flexion and abduction at 7 and 14 days after operation, and hip function recovery at 1, 3, and 6 months after surgery as well as activity of daily living(ADL) were also observed and compared between the two groups.Results The resting and active VAS scores at 6 h, 12 h, 24 h, and 48 h after operation in research group were significantly lower than those in control group(P<0.05). There were no significant differences in the preoperative MoCA scores between the two groups(P>0.05).After operation the MoCA scores in both groups were significantly lower than those before operation(P<0.05). In addition, the post-MoCA scores in research group were significantly lower than those in control group(P<0.05). The incidence rates of postoperative delirium, nausea and vomiting and dizziness in research group were significantly lower than those in control group(P<0.05). However there were no significant differences in the incidence rates of drowsiness, itchy skin and urinary retention between the two groups(P>0.05). The hip flexion and abduction at 7 and 14 days after operation as well as the Harris hip function scores and Barthel scores at 1 m, 3 m and

关 键 词：鸡尾酒式镇痛复合液 髋部骨折 认知功能 髋关节功能 

分 类 号：R683.3[医药卫生—骨科学]