“鸡尾酒”混合剂注射在肩关节镜下肩袖修补术后的疗效观察  

作　　者：付志强 何飞熊[1] 王巍[1] 谢俊[1] 洪胜坤 郭金库 

机构地区：[1]浙江省衢州市人民医院,324000

出　　处：《浙江临床医学》2023年第11期1647-1648,1651,共3页Zhejiang Clinical Medical Journal

基　　金：衢州市指导性科技项目(2021026)。

摘　　要：目的探讨“鸡尾酒”混合剂局部注射在肩关节镜下肩袖修补术后改善早期疼痛、出血、肿胀的效果。方法2020年2月至2022年2月行肩关节镜下肩袖修补术的患者60例,随机分为观察组与对照组各30例。观察组术后盂肱关节及肩峰下间隙各注射25 mL“鸡尾酒”混合剂(复方倍他米松注射液1 mL+罗哌卡因100 mg+氨甲环酸1 g+0.9%氯化钠溶液共50 mL),对照组在相同部位注射0.9%氯化钠溶液50 mL。观察术前、术后第1天血红蛋白含量值,测量肩关节术前、术后第1、2天的周径,并计算出肩关节的周径差值,观察患者皮下瘀斑,出现深静脉血栓等并发症。应用视觉模拟疼痛评分(VAS)和Constant-Murley肩关节功能评分表观察患者疼痛和肩关节功能恢复情况2结果术前及术后第1天两组血红蛋白含量值比较,差异无统计学意义(P>0.05);术后第1、2天观察组患者肩关节周径差值分别为(4.6±0.6)cm,(1.8±0.2)cm,均低于对照组(5.3±0.4)cm,(2.2±0.1)cm,差异有统计学意义(P<0.05)。观察组3例患者出现皮下瘀斑,对照组5例患者出现皮下瘀斑,两组比较差异无统计学意义(P>0.05);两组患者均未发生深静脉血栓。术后第1、2天观察组VAS评分分别为(3.5±0.8)分,(2.3±0.6)分,均低于对照组(4.4±0.7)分,(3.0±0.4)分,差异有统计学意义(P<0.05);两组患者术后评分比术前改善,术后第1、3个月肩关节功能评分差异无统计学意义(P>0.05)。结论肩关节镜下肩袖缝合术后局部“鸡尾酒”混合剂注射疗法能减轻患者术后早期疼痛,软组织肿胀,增加患者术后满意度,安全性好,方法简便有效,值得临床推广。Objective To investigate the effect of local injection of cocktail on early pain,bleeding and swelling after shoulder rotator cuff repair under arthroscopy.Methods From February 2020 to February 2022,60 patients undergoing shoulder arthroscopic rotator cuff repair were randomly divided into the observation group and the control group,30 patients in each group.The observation group was injected with 25 mL cocktail solution(compound betamethasone injection 1 mL+ropivacaine 100 mg+tranexamic acid 1 g+0.9%sodium chloride solution 50 mL)and the control group was injected with 0.9%sodium chloride solution 50 mL at the same site.Hemoglobin content was observed before surgery and on the first day after surgery,circumference of shoulder joint was measured before surgery and on the first and second days after surgery,and the difference of circumference of shoulder joint was calculated.Subcutaneous ecchymosis and complications such as deep vein thrombosis were observed.Visual analogue pain scale(VAS)and Constant-Murley shoulder function scale were used to observe the pain and shoulder function recovery of patients.Results There was no significant difference in hemoglobin content between the two groups before surgery and the first day after surgery(P>0.05).The difference of shoulder circumference diameter in the observation group was(4.6±0.6)cm and(1.8±0.2)cm,respectively,on the 1st and 2nd day after surgery,which were lower than those in the control group(5.3±0.4)cm and(2.2±0.1)cm,and the difference was statistically significant(P<0.05).Subcutaneous ecchymosis occurred in 3 patients in the observation group and 5 patients in the control group,and there was no statistical significance between the two groups(P>0.05).No deep vein thrombosis occurred in both groups.The VAS scores of the observation group were(3.5±0.8)points and(2.3±0.6)points on the 1st and 2nd day after surgery,respectively,which were lower than those of the control group(4.4±0.7)points and(3.0±0.4)points,and the differences were statistically signific

关 键 词：肩关节镜 肩袖修补 “鸡尾酒”混合剂 

分 类 号：R687.4[医药卫生—骨科学]