颊针在全膝关节置换术后多模式镇痛中的疗效观察  

Efficacy Observation of Buccal Acupuncture in Multimodal Analgesia after Total Knee Arthroplasty

作　　者：周红梅[1] 蒋晨浩 张建楠[1] 尹卫娟[1] Zhou Hongmei;Jiang Chenhao;Zhang Jiannan;Yin Weijuan(Wuxi Traditional Chinese Medicine Hospital,Jiangsu,Wuxi 214000,China)

机构地区：[1]江苏省无锡市中医医院,江苏无锡214000

出　　处：《中国中医急症》2022年第4期677-680,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：无锡市卫生健康委科技成果与适宜技术推广项目(T201944)。

摘　　要：目的观察颊针在全膝关节置换术后多模式镇痛中的临床效果。方法将60例全膝关节置换手术患者随机分为观察组与对照组各30例,对照组采用单次股神经阻滞后复合舒芬太尼静脉PCA镇痛方案,观察组采用颊针配合单次股神经阻滞后复合舒芬太尼静脉PCA镇痛方案,观察并记录两组患者术后不同时间段静息状态及运动状态的疼痛数字分级法(NRS)评分、膝关节的主动屈曲度及被动屈曲度、股四头肌肌力评分、镇痛泵按压次数、输入总药量及不良反应发生率来评价效果。结果观察组术后12、24 h静息时和术后12、24、48 h活动时NRS评分均低于对照组(P<0.05)。观察组术后12、24、48、72 h膝关节主动伸屈度和术后24、48、72 h膝关节被动伸屈度均大于对照组(P<0.05)。观察组术后2、12、24 h股四头肌肌力均大于对照组(P<0.05)。观察组术后48 h镇痛泵按压次数、镇痛泵输入量、恶心呕吐发生率均低于对照组(P<0.05)。结论颊针在全膝关节术后镇痛效果明显,减少了术后镇痛药物用量,副作用更小,在早期关节功能康复方面效果确切。Objective:To observe the clinical effect of buccal acupuncture in multimodal analgesia after total knee arthroplasty(TKA).Methods:A total of 60 patients underwent TKA were randomized into an observation group and a control group,30 cases in each group.The control group was treated with single femoral nerve block combined with sufentanil intravenous PCA.The observation group was treated with buccal acupuncture combined with single femoral nerve block combined with sufentanil intravenous PCA.The postoperative resting state in different times and motion state of NRS scores,active flexion and passive flexion of knee joint,quadriceps muscle strength rating,analgesia pump pressure,input total dose and incidence of adverse reactions of the two groups were observed and recorded to evaluate the effect.Results:The NRS score of the observation group was lower than that of the control group at rest 12 and 24 h after surgery and at activity 12,24 and 48h after surgery(P<0.05).The active extension of knee joint at 12,24,48 and 72 h after surgery and the passive extension of knee joint at 24,48 and 72 h after surgery in the observation group were higher than those in the control group(P<0.05).The muscle strength of quadriceps in the observation group was higher than that in the control group at 2,12 and 24 h after surgery(P<0.05).The pressure times of analgesic pump,the input amount of analgesic pump and the incidence of nausea and vomiting in the observation group were all lower than those in the control group at 48 h after operation(P<0.05).Conclusion:Buccal acupuncture has obvious analgesic effect on postoperative TKA,which can reduce the amount of postoperative analgesic drugs,has fewer side effects,and is effective in early rehabilitation of joint function.

关 键 词：全膝关节置换术 颊针 股神经阻滞 静脉镇痛 功能康复 

分 类 号：R684[医药卫生—骨科学]