消肿止痛合剂对膝关节置换术患者应激反应的影响  

作　　者：柴喜平[1] 尤从新[1] 张锐[1] 贾潇[1] 李爱强[1] 

机构地区：[1]甘肃省中医院,甘肃兰州730050

出　　处：《西部微创骨科》2018年第1期37-40,共4页Western Journal of Minimally Invasive Orthopedics

基　　金：2013年甘肃省科技计划资助(编号:1308RJZA160)。

摘　　要：目的:探讨消肿止痛合剂联合曲马多对人工膝关节置换术后的影响。方法:选择人工膝关节置换术的患者60例为研究对象,按随机法分为观察组和对照组,每组30例,对照组术后予曲马多治疗,观察组术后予消肿止痛剂配合曲马多治疗,治疗1周后,比较2组患者在术后第12h、24h、48h、7d的VAS评分和膝关节HSS评分。采用酶联免疫吸附法(ELISA)分别测定2组患者术前、术后及术后1周、4周血清中白介素l(IL-l)、肿瘤坏死因子α(TNF-α)、基质蛋白酶l(MMP-l)的水平含量。结果:观察组患者在术后第48h和7d静息疼痛和活动时疼痛VAS评分明显低于对照组,同时观察组患者在术后第48h和7d膝关节HSS评分明显高于对照组,差异均具有统计学意义(P<0.05)。观察组患者在术后1周和4周血清IL-1、TNF-α及MMP-1水平明显低于对照组,差异具有统计学意义(P<0.05).观察组患者不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05).结论:消肿止痛合剂配合曲马多用于膝关节置换术后患者的镇痛和改善膝关节活动疗效显著,并可降低患者血清中炎症因子IL-l、TNF-α及MMP-1的表达水平,其机制值得进一步探讨研究。Objective:To explore the influence of XiaoZhong ZhiTong mixture combined wi th tramadol on the patients after total knee arthroplasty(TKA).Methods:Sixty patients who accepted TKA in our hospital were chosen as the objects of the study,and allocated to the observation group and the control group according to random method,30 cases in each group,the control group accepted tramadol after the operation,and the observation group took XiaoZhong ZhiTong mixture combined with tramadol after the operation,after treating for one week,VAS and HSS scales of the knee in both groups were compared in 12 hours,24 hours,48 hours and seven days af ter the operation.The contents of MMP-1,TNF-α and IL-1 in the serum of the patients in both groups were detected by ELISA method before the surgery,after the surgery,in one week and four weeks after the surgery.Results:The observationgroup was lower than the control group in VAS scales when the patients rested and moved in seven days and 48 hours after the surgery,simultaneously higher than the control group in HSS scales of the knee in seven days and 48 hours after the surgery,and the difference had statistical meaning(P<0.05).The observation group was lower than the control group in the contents of MMP-1,TNF-α and IL-1 in one week and four weeks after the surgery,and the difference showed statistical meaning(P<0.05).The observation group was lower than the control group in the incidence of adverse reaction,and the difference had statistical meaning(P<0.05).Conclusion:XiaoZhongZhiTong mixture combined with tramadol is applied to the analgesia of the patients after TKA,and effective in improve knee joint movement,decrease the contents of MMP-1,TNF-α and IL-1 in the serum of the patients,and its mechanism is worth further studying.

关 键 词：消肿止痛合剂 膝骨性关节炎 膝关节置换术 镇痛。 

分 类 号：R68[医药卫生—骨科学]