不同镇痛方式对老年髋关节置换患者血液流变学及血小板活化的影响比较  

Comparison on Influence of Different Analgesia Modes for Hemorheology and Platelet Activation of Elderly Patients with Hip Replacement

作　　者：杨奎 余瑛 YANG Kui;YU Ying(Shaowu Municipal Hospital,Shaowu 354000,China;不详)

机构地区：[1]邵武市立医院,福建邵武354000

出　　处：《中外医学研究》2023年第16期45-48,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究并比较不同镇痛方式对老年髋关节置换患者血液流变学及血小板活化的影响。方法:将2020年2月—2022年3月邵武市立医院收治的80例老年髋关节置换患者作为研究对象,根据随机数表法将其分为A组40例和B组40例。A组术后进行静脉自控镇痛,B组术后进行硬膜外自控镇痛。比较两组手术前后疼痛程度[视觉模拟评分法(VAS)评分)]、血液流变学指标(全血高切、低切黏度及全血还原黏度、血浆黏度及血细胞比容)及血小板活化指标(CD41、CD61及CD63)。结果:两组术前VAS评分、血液流变学指标及血小板活化指标比较,差异无统计学意义(P>0.05),B组术后12 h、24 h、48 h的VAS评分、血液流变学指标及血小板活化指标均显著低于A组,差异有统计学意义(P<0.05)。结论:硬膜外自控镇痛对老年髋关节置换患者术后疼痛的控制效果优于静脉自控镇痛,且可更为有效地控制血液流变学及血小板活化状态,在老年髋关节置换患者术后血栓防控中的效果较好。Objective:To investigate and compare the influence of different analgesia modes for hemorheology and platelet activation of elderly patients with hip replacement.Method:A total of 80 elderly patients with hip replacement in Shaowu Municipal Hospital from February 2020 to March 2022 were selected as the study objects and they were divided into group A of 40 cases and group B of 40 cases according to the random number table method.Group A was treated with patient-controlled intravenous analgesia,group B was treated with patient-controlled epidural analgesia.Then the pain degree[visual analog scale(VAS)score],hemorheology indexes(whole blood high shear viscosity,low shear viscosity,whole blood reduced viscosity,plasma viscosity and hematocrit)and platelet activation indexes(CD41,CD61 and CD63)of two groups before and after operation were compared.Result:There were no significant differences in the VAS score,hemorheology indexes and platelet activation indexes between two groups before operation(P>0.05);the VAS score,hemorheology indexes and platelet activation indexes of group B after 12 h,24 h,48 h of surgery were lower than those of group A,the differences were statistically significant(P<0.05).Conclusion:The control effect of patient-controlled epidural analgesia for the pain of elderly patients with hip replacement is better than that of patient-controlled intravenous analgesia,and it can more effectively control the hemorheology and platelet activation state,so its prevention and control effect for the postoperative thrombosis of elderly patients with hip replacement is better.

关 键 词：老年髋关节置换 静脉自控镇痛 硬膜外自控镇痛 血液流变学 血小板活化 

分 类 号：R614[医药卫生—麻醉学]