鸡尾酒疗法联合连续股神经阻滞在膝关节周围恶性骨肿瘤患者术后镇痛中的应用效果  

Application effects of cocktail therapy combined with continuous femoral nerve block in postoperative analgesia of patients with malignant bone tumors around the knee joint

作　　者：张继珂 王振雷 王丽丽[1] ZHANG Jike;WANG Zhenlei;WANG Lili(Department of Anesthesiology of the Third People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第三人民医院麻醉科,河南郑州450000

出　　处：《中国民康医学》2024年第4期59-61,65,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察鸡尾酒疗法联合连续股神经阻滞(FNB)在膝关节周围恶性骨肿瘤患者术后镇痛中的应用效果。方法:选取2020年9月至2022年9月于该院行全膝关节置换术(TKA)的107例膝关节周围恶性骨肿瘤患者进行前瞻性研究,采用随机数字表法将其分为对照组53例和观察组54例。对照组术后给予FNB镇痛,观察组在对照组基础上联合鸡尾酒疗法镇痛,比较两组术后疼痛程度[被动活动视觉模拟评分表(PVAS)、静息状态视觉模拟评分表(RVAS)]评分、下肢微循环指标[足背动脉血流量、踝肱指数(ABI)]水平和血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平。结果:观察组术后24、48 h的RVAS、PVAS评分均低于对照组,差异有统计学意义(P<0.05);术后48 h,两组足背动脉血流量、ABI均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);术后48 h,两组TNF-α、IL-6、CRP水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。结论:鸡尾酒疗法联合FNB应用于膝关节周围恶性骨肿瘤患者术后镇痛可提高下肢微循环指标水平,降低RVAS评分、PVAS评分和血清炎性因子水平,效果优于单纯FNB镇痛。Objective:To observe effects of cocktail therapy combined with continuous femoral nerve block(FNB)on postoperative analgesia in patients with malignant bone tumors around the knee joint.Methods:A prospective study was conducted on 107 patients with malignant bone tumors around the knee joint who underwent total knee arthroplasty(TKA)in this hospital from September 2020 to September 2022.They were divided into control group(53 cases)and observation group(54 cases)by using the random number table method.The control group was given FNB analgesia after the surgery,while the observation group was combined with cocktail therapy on the basis of that of the control group.The postoperative pain degree[visual analogue scale for passive motion(PVAS),visual analogue scale for resting state(RVAS)]score,the lower limb microcirculation index[dorsalis pedis artery blood flow,ankle brachial index(ABI)]levels,and the serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]level were compared between the two groups.Results:The RVAS and PVAS scores of the observation group 24 and 48 h after the surgery were lower than those of the control group,and the differences were statistically significant(P<0.05).48 h after the surgery,the blood flow of dorsalis pedis artery and ABI in the two groups were lower than those before the surgery,but those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).48 h after the surgery,the levels of TNF-α,IL-6 and CRP in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Cocktail therapy combined with FNB for postoperative analgesia in the patients with malignant bone tumors around the knee joint can improve the levels of lower limb microcirculation indexes,reduce the RVAS scores,the PVAS scores and the serum inflammatory factor l

关 键 词：鸡尾酒疗法 连续股神经阻滞 全膝关节置换术 膝关节周围恶性骨肿瘤 血清炎性因子 下肢微循环 

分 类 号：R641[医药卫生—外科学]