塞来昔布联合氨酚羟考酮多模式超前镇痛对老年股骨颈骨折患者围术期疼痛及术后早期髋关节功能的影响  

Effect of multimodal preemptive analgesia on perioperative pain and early postoperative hip function in patients with femoral neck fracture undergoing artificial bipolar femoral head replacement

作　　者：尹合勇 郭艾[1] 马立峰[1] 刁乃成[1] 杨金江[1] 喻飞[1] 杨波[1] YIN He-yong;GUO Ai;MA Li-feng(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2022年第10期1074-1078,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金青年项目(编号:82002285)。

摘　　要：目的探讨塞来昔布联合氨酚羟考酮多模式超前镇痛对股骨颈骨折行人工双极股骨头置换患者围术期疼痛及术后早期髋关节功能的影响。方法采用前瞻性研究方法,选取2019年9月至2021年3月期间因股骨颈骨折于首都医科大学附属北京友谊医院骨科行人工双极股骨头置换术的64例患者作为研究对象,随机数字表法均分为两组。干预组给予多模式超前镇痛,术前开始口服塞来昔布,术后塞来昔布联合氨酚羟考酮片;对照组仅术后口服塞来昔布。比较两组患者一般情况、平均住院时间、围术期疼痛视觉模拟评分法(VAS)以及术后早期髋关节Harris评分等。结果干预组平均住院时间为(8.09±0.96)d,明显短于对照组[(9.41±1.54)d],差异有统计学意义(P<0.05)。术后2 d、术后2周,干预组静息VAS评分为(3.56±0.80)、(1.75±0.67)分,均显著低于对照组[(6.38±0.87)、(2.19±0.82)分],差异均有统计学意义(P<0.05)。术后2 d、2周、6周,干预组活动VAS评分为(6.28±0.81)、(2.34±0.65)、(1.44±0.50)分,均明显低于对照组[(7.53±0.72)、(3.31±0.86)、(2.94±0.56)分],差异均有统计学意义(P<0.05)。术后6周,干预组的Harris评分总分为(86.56±4.13)分,明显高于对照组[(72.81±5.36)分],差异有统计学意义(P<0.05)。结论采用塞来昔布联合氨酚羟考酮片的多模式超前镇痛可显著缓解股骨颈骨折行人工双极股骨头置换患者的围术期疼痛,缩短住院时间,有利于术后快速康复,获得更好的髋关节功能。Objective To investigate the effects of multimodal preemptive analgesia on perioperative pain and hip function in patients with femoral neck fracture.Methods A prospective study method was adopted.Totally,64 patients who underwent artificial bipolar femoral head replacement in our department due to femoral neck fracture from September 2019 to March 2021 were selected.Those patients were randomly divided into two groups.The intervention group was received multimodal preemptive analgesia:medication of celecoxib was started before operation,and celecoxib combined with paracetamol/oxycodone tablets were given after operation.The control group only received celecoxib orally after operation.The general clinical data,average hospitalization time,perioperative pain visual analogue scale(VAS),and postoperative hip joint Harris score in the early stage were compared between the two groups.Results The average hospitalization time in the intervention group was(8.09±0.96)days,which was significantly shorter than that in the control group[(9.41±1.54)days],the difference was statistically significant(P<0.05).At 2 days after operation and 2 weeks after operation,the resting VAS scores of the intervention group were(3.56±0.80)points,(1.75±0.67)points,which were significantly lower than those of the control group[(6.38±0.87)points,(2.19±0.82)points],the differences were statistically significant(P<0.05).At 2 days after operation,2 weeks after operation,and 6 weeks after operation,the active VAS scores of the intervention group were(6.28±0.81)points,(2.34±0.65)points,and(1.44±0.50)points,which were significantly lower than those of the control group[(7.53±0.72)points,(3.31±0.86)points,(2.94±0.56)points],the differences were statistically significant(P<0.05).At 6 weeks after operation,the total Harris score of the intervention group were(86.56±4.13)points,which were significantly higher than those of the control group[(72.81±5.36)points],the differences were statistically significant(P<0.05).Conclusion Multimodal preem

关 键 词：股骨颈骨折 人工双极股骨头置换 超前镇痛 围术期疼痛 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]