B超引导下膝关节后囊间隙阻滞联合收肌管阻滞应用于全膝关节置换术患者中的效果  

Application Effect of B-ultrasound Guided Interspace between the Popliteal Artery and the Capsule of the Posterior Knee Block Combined with Adductor Canal Block in Patients Undergoing Total Knee Arthroplasty

作　　者：王猛全 林月娥 WANG Mengquan;LIN Yue’e(不详;Dehua County Hospital,Dehua 362500,China)

机构地区：[1]德化县医院,福建德化362500

出　　处：《中外医学研究》2022年第22期38-41,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察B超引导下膝关节后囊间隙(IPACK)阻滞联合收肌管阻滞(ACB)应用于全膝关节置换术(TKA)患者中的效果。方法:选取德化县医院2019年11月-2021年10月进行TKA的60例患者为研究对象,采用随机数字表法将纳入患者随机分为对照组和联合组,每组30例。对照组进行B超引导下ACB,联合组采用B超引导下IPACK联合ACB。比较两组术后2、6、12、24 h静息状态和运动状态下疼痛程度,术后12、24、48、72 h膝关节活动度、股四头肌肌力,并比较两组术后康复情况。结果:联合组术后2、6、12 h静息状态及运动状态下疼痛视觉模拟评分法(VAS)评分均显著低于对照组(P<0.05);联合组术后12、24、48 h膝关节活动度均显著大于对照组(P<0.05);联合组术后12、24、48 h股四头肌肌力均显著大于对照组(P<0.05);联合组术后首次镇痛补救时间、补救镇痛次数及首次下床时间均显著优于对照组(P<0.05)。结论:B超引导下IPACK联合ACB可有效缓解TKA患者术后疼痛,提高术后早期关节活动度,并降低对股四头肌肌力的影响,从而更有助于促进患者术后康复。Objective:To observe the application effect and safety of B-ultrasound guided interspace between the popliteal artery and the capsule of the posterior knee(IPACK)block combined with adductor canal block(ACB)undergoing total knee arthroplasty(TKA).Method:A total of 60 patients undergoing TKA in Dehua County Hospital were enrolled as the research objects from November 2019 to October 2021.According to random number table method,they were divided into control group and combination group,30 cases in each group.ACB under B-ultrasound guidance was performed in the control group,and IPACK under B-ultrasound guidance was combined with ACB in the combination group.The pain degree in rest and motion state at 2,6,12 and 24 hours after surgery,knee range of motion and muscle strength of quadriceps at 12,24,48 and 72 hours after surgery,postoperative rehabilitation between the two groups were compared.Result:At 2,6 and 12 hours after surgery,scores of visual analogue scale(VAS)in rest and motion state in combination group were significantly lower than those in control group(P<0.05).At 12,24 and 48 hours after surgery,knee range of motion in combination group were significantly greater than those in the control group(P<0.05),and muscle strength of quadriceps at 12,24 and 48 hours were significantly stronger than that in control group(P<0.05).The remedial time of first analgesia,remedial times of analgesia and the first leaving bed time in combination group were significantly better than those in control group(P<0.05).Conclusion:B-ultrasound guided IPACK combined with ACB can effectively alleviate postoperative pain of TKA patients,improve early postoperative joint range of motion and reduce the effects on quadriceps muscle strength,which is more beneficial to promote postoperative recovery of patients.

关 键 词：膝关节后囊间隙阻滞 收肌管阻滞 全膝关节置换术 

分 类 号：R614[医药卫生—麻醉学]