降阶梯艾瑞昔布联合高位髂筋膜阻滞术用于老年股骨粗隆骨折半髋关节置换术后的镇痛效果  

Clinical Analgesia Effect of Stepdown Imrecoxib Combined with High Iliac Fascia Block in the Treatment of Femoral Trochanteric Fracture after Hemiarthroplasty in Elderly Patients

作　　者：杜伟斌[1] 华爱兰 李勇[1] 陈荣良[1] 沈福祥 曹国平[1] DU Weibin;HUA Ailan;LI Yong;CHEN Rongliang;SHEN Fuxiang;CAO Guoping(Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine,Hangzhou 311200,China;不详)

机构地区：[1]浙江中医药大学附属江南医院杭州市萧山区中医院,浙江杭州311200

出　　处：《中国医学创新》2022年第16期14-18,共5页Medical Innovation of China

基　　金：中国初级卫生保健基金会“医路珍艾”项目(YLZA-20210001);杭州市卫生科技计划项目(B20200155);杭州市萧山区社会发展重大科技计划项目(2020322)。

摘　　要：目的:探讨降阶梯艾瑞昔布联合高位髂筋膜阻滞术在老年股骨粗隆骨折半髋关节置换术后的镇痛效果。方法:回顾性分析2018年5月-2020年8月杭州萧山中医院收治的60例行老年股骨粗隆骨折半髋关节置换术患者的临床资料,根据术后镇痛方式不同将其分为联合治疗组(降阶梯艾瑞昔布联合高位髂筋膜阻滞术)和单纯治疗组(高位髂筋膜阻滞术),每组30例。比较两组视觉模拟评分法(VAS)评分,术后髋关节功能(Harris)评分,术后下床活动时间、住院时间及并发症发生情况。结果:术后6 h,两组静息和活动状态下的VAS评分比较,差异均无统计学意义(P>0.05)。术后24、48、72 h和术后1周,联合治疗组静息和活动状态下的VAS评分均低于单纯治疗组,差异均有统计学意义(P<0.05)。术前,两组髋关节功能评分比较,差异无统计学意义(P>0.05)。术后2周、术后1个月,联合治疗组髋关节功能评分均高于单纯治疗组,差异均有统计学意义(P<0.05)。术后3、6个月,两组髋关节功能评分比较,差异均无统计学意义(P>0.05)。联合治疗组术后下床活动时间和住院时间均短于单纯治疗组,差异均有统计学意义(P<0.05)。联合治疗组发生1例手术部位局部红肿,单纯治疗组出现1例下肢神经麻木。结论:降阶梯艾瑞昔布联合高位髂筋膜阻滞术在老年股骨粗隆骨折半髋关节置换术后有更好的术后镇痛效果,可促进患者早期功能锻炼,缩短住院时间,提高生活质量。Objective:To investigate the analgesia effect of stepdown Imrecoxib combined with high iliac fascia block in the treatment of femoral trochanteric fracture after hemiarthroplasty in elderly patients.Method:The clinical data of 60 elderly patients underwent hemiarthroplasty for femoral trochanteric fracture admitted to Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine from May 2018 to August 2020 were retrospectively analyzed,according to different postoperative analgesia methods,the patients were divided into the combined treatment group(stepdown Imrecoxib combined with high iliac fascia block) and the single treatment group(high iliac fascia block),with 30 cases in each group.Visual analogue scale(VAS) score,postoperative hip function(Harris) score,postoperative ambulation time,length of hospital stay and complications were compared between two groups.Result:6 h after surgery,there were no significant differences in VAS scores at rest and activity between two groups(P>0.05).24,48,72 h and 1 week after surgery,VAS scores at rest and activity in the combined treatment group were lower than those in the single treatment group,the differences were statistically significant(P<0.05).Before surgery,there was no significant difference in hip function scores between two groups(P>0.05).2 weeks and 1 month after surgery,the hip function scores in the combined treatment group were higher than those in the single treatment group,the differences were statistically significant(P<0.05).3 and 6 months after surgery,there were no significant differences in hip function scores between two groups(P>0.05).The postoperative ambulation time and hospital stay in the combined treatment group were shorter than those in the single treatment group,the differences were statistically significant(P<0.05).Local redness occurred in 1 case in the combined treatment group,and nerve numbness occurred in 1 case in the single treatment group.Conclusion:Stepdown Imrecoxib combined with high iliac fascia block has better postoperative analges

关 键 词：股骨粗隆骨折 半髋关节置换术 艾瑞昔布 髂筋膜阻滞术 镇痛 

分 类 号：R614[医药卫生—麻醉学]