鸡尾酒疗法镇痛治疗对老年膝关节置换患者术后疼痛程度及炎症因子的影响  

Effects of cocktail analgesia therapy on pain level and inflammatory factors in elderly patients after TKA

作　　者：李廷 靖智利 吴迪[1] LI Ting;JING Zhi-li;WU Di(Department of Anesthesiology,Beijing Luhe Hospital,Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院麻醉科,北京101100

出　　处：《川北医学院学报》2024年第2期243-246,256,共5页Journal of North Sichuan Medical College

基　　金：潞河医院首都临床特色应用研究项目(KJ2019CX012-19)。

摘　　要：目的:探讨鸡尾酒疗法镇痛治疗对老年膝关节置换患者术后疼痛程度及炎症因子水平的影响。方法:选取90例接受全膝关节置换术的老年患者为研究对象,根据镇痛治疗方式不同分为观察组和对照组,每组各45例。观察组患者术中予以鸡尾酒式镇痛+术后静脉自控镇痛(PCIA)治疗;对照组患者只予以PCIA治疗。比较两组患者疼痛程度[视觉模拟(VAS)评分]、肿胀度、活动度、炎症因子[白细胞(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)]水平及术后1个月膝关节功能[膝关节评分法(KSS)评分]。结果:术后12、24 h,观察组患者静息及运动状态下VAS评分低于对照组(P<0.05);术后1、3、7 d,观察组患者膝关节肿胀度低于对照组(P<0.05),活动度高于对照组(P<0.05);术后1、7 d,观察组患者WBC、PCT、CRP、TNF-α和IL-10水平低于对照组(P<0.05);术后1个月,观察组患者KSS评分高于对照组(P<0.05)。结论:鸡尾酒疗法对老年膝关节置换患者有良好的镇痛效果,可减轻炎症反应,更有利于患者术后膝关节功能的恢复,具有一定的临床推广价值。Objective:To explore the effects of cocktail analgesia therapy on pain level and inflammatory factors in elderly patients after total knee arthroplasty(TKA).Methods:In the 90 elderly patients undergoing TKA,there were 45 cases in observation group(cocktail therapy for analgesia)and 45 cases in control group[routine patient-controlled intravenous analgesia(PCIA)for analgesia].The the pain levels[Visual Analog Scale(VAS)score],swelling degree,range of motion,inflammatory factors[white blood cells(WBC),procalcitonin(PCT),C-reactive protein(CRP),and tumor necrosis factorα(TNF-α),Interleukin-10(IL-10)]and and knee joint function at 1 month after surgery[knee joint scoring system(KSS)score]in the two groups were compared.Results:At 12 and 24 h after surgery,scores of VAS under rest and motion state were lower in observation group than in control group(P<0.05).At 1,3 and 7 d after surgery,knee swelling was milder in observation group than in control group,and range of motion was greater in observation group(P<0.05).At 1 and 7 d after surgery,WBC,PCT,CRP,TNF-α,and IL-10 were lower in observation group than in control group(P<0.05).At 1 month after surgery,KSS score was higher in observation group than in control group(P<0.05).Conclusion:Cocktail therapy has good analgesia effect in elderly patients after TKA,which can reduce inflammation level and is more conducive to postoperative recovery of knee function,with certain clinical value.

关 键 词：鸡尾酒疗法 全膝关节置换术 疼痛 血清炎症因子 

分 类 号：R614[医药卫生—麻醉学]