超前镇痛在经皮椎体成形术治疗老年骨质疏松性胸腰椎骨折的临床研究  

Clinical study of preemptive analgesia in treatment of senile osteoporotic thoracolumbar fracture by percutaneous vertebroplasty

作　　者：孙逊 孙家财[1] 葛迅[1] 陈正 SUN Xun;SUN Jia-cai;GE Xun;CHEN Zheng(Hexian People’s Hospital,Ma’anshan 238200,Anhui,China)

机构地区：[1]和县人民医院,安徽马鞍山238200

出　　处：《生物医学工程与临床》2024年第2期205-209,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的观察超前镇痛在经皮椎体成形术治疗老年骨质疏松性胸腰椎骨折患者疼痛的临床疗效。方法选择单个胸腰椎体压缩性骨折的老年骨质疏松患者80例,其中男性32例,女性48例;年龄65~85岁,平均年龄71.3岁;胸椎骨折38例,腰椎骨折42例。使用随机数字表法将患者分为试验组(超前镇痛组)40例和对照组(安慰剂组)40例,分别予注射盐酸布桂嗪注射液和0.9%氯化钠溶液(生理盐水注射液)。所有患者均行经皮椎体成形术,观察并记录患者在局部麻醉药物注射前、穿刺过程中、骨水泥推注过程中和术后6 h视觉模拟量表(VAS)评分、动脉压、心率,以及两组手术时间、术中不良反应和术后患者满意度。结果局部麻醉药物注射前两组患者VAS评分、动脉压及心率差异无统计学意义(P>0.05)。穿刺过程中及骨水泥推注过程中试验组VAS评分、动脉压、心率均低于对照组且差异有统计学意义[穿刺过程中:(3.56±0.87)分vs(4.75±0.94)分、(96.25±7.42)mmHg vs(99.75±7.64)mmHg、(88.45±7.84)次/分vs(90.42±7.94)次/分;骨水泥推注过程中:(4.25±0.35)分vs(5.16±0.45)分、(98.45±7.52)mmHg vs(102.66±8.65)mmHg、(94.78±7.58)次/分vs(98.44±7.45)次/分。P<0.05]。术后6 h两组患者VAS评分、动脉压及心率差异无统计学意义(P>0.05)。试验组手术时间少于对照组,差异有统计学意义[(37.47±5.80)min vs(39.18±6.30)min。P<0.05]。两组患者在术中不良反应上差异无统计学意义(P>0.05)。试验组患者满意度明显优于对照组且差异有统计学意义[87.5%(35/40)vs 60.0%(24/40)。P<0.05]。结论超前镇痛应用于经皮椎体成形术治疗老年骨质疏松性骨折可以有效缓解患者术中疼痛,降低患者对手术疼痛恐惧,减少手术时间,保证患者安全,增加患者满意度,值得临床推广应用。Objective To observe the clinical efficacy of preemptive analgesia in percutaneous vertebroplasty for treatment of pain in senile osteoporotic thoracolumbar fractures.Methods A total of 80 senile osteoporosis patients with single thoracolumbar vertebral compression fracture were enrolled,which included 32 males and 48 females,aged 65-85 years old with mean age of 71.3 years old.There were 38 cases of thoracic fracture and 42 of lumbar fracture.All of them were divided into preemptive analgesia group(experimental group,n=40,injected with bucinnazine hydrochloride injection)and placebo group[control group,n=40,injected with 0.9%sodium chloride solution(normal saline injection)]by random number table method.All of them performed percutaneous vertebroplasty,the visual analogue scale(VAS)score,arterial pressure and heart rate before local anesthetic injection,during puncture,during bone cement injection and 6-hour post operation were observed and recorded.The operation time,intraoperative adverse reactions and postoperative patient satisfaction of 2 groups were observed and recorded.Results There was no significant difference in pain score,arterial pressure and heart rate before local anesthetic injection between 2 groups(P>0.05).During the process of puncture and bone cement injection,the VAS score,arterial pressure and heart rate of experimental group were statistically significantly lower than those of control group[process of puncture:(3.56±0.87)scores vs(4.75±0.94)scores,(96.25±7.42)mmHg vs(99.75±7.64)mmHg,(88.45±7.84)times/minutes vs(90.42±7.94)times/minutes;process of bone cement injection:(4.25±0.35)scores vs(5.16±0.45)scores,(98.45±7.52)mmHg vs(102.66±8.65)mmHg,(94.78±7.58)times/minutes vs(98.44±7.45)times/minutes.P<0.05].There was no significant difference in VAS score,arterial pressure and heart rate 6-hour post operation between 2 groups(P>0.05).The operation time of experimental group was statistically significantly less than that of control group,and the difference was statistically significa

关 键 词：超前镇痛 经皮椎体成形术 胸腰椎骨折 临床研究 骨质疏松 老年人 

分 类 号：R687.3[医药卫生—骨科学] R589.5[医药卫生—外科学]