膝关节置管镇痛技术在膝关节镜手术后镇痛中的应用效果  

Application effect of knee joint catheterization analgesia technology in postoperative pain relief after knee arthroscopic surgery

作　　者：赖建鸿 黄金 曾海英 林鹰 LAI Jianhong;HUANG Jin;ZENG Haiying;LIN Ying(Department of Anesthesiology,Ganzhou Hospital of TCM,Jiangxi Province,Ganzhou341000,China;Operating Room,Ganzhou Hospital of TCM,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市中医院麻醉科,江西赣州341000 [2]江西省赣州市中医院手术室,江西赣州341000

出　　处：《中国当代医药》2024年第22期85-89,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220227095)。

摘　　要：目的探讨膝关节置管镇痛技术在膝关节镜手术后镇痛中的应用效果。方法选取2022年7月至2023年11月赣州市中医院收治的60例膝关节镜手术患者为研究对象,按照随机数字表法分为试验组与对照组,每组各30例。对照组术后经静脉输注镇痛药物进行镇痛干预,试验组术后实施膝关节置管镇痛技术干预。比较两组患者的术后镇痛效果、术后康复时间、血清炎症因子、应激反应指标、不良反应发生率。结果试验组术后6、12、24、36 h时的视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。试验组的术后开始下床时间、开始功能锻炼时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术后24 h,试验组的血清应激反应指标[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)]水平均低于对照组,差异有统计学意义(P<0.05)。术后24 h,试验组的白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)水平均低于对照组,差异有统计学意义(P<0.05)。试验组的不良反应总发生率为6.67%(2/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论膝关节置管镇痛技术在膝关节镜手术后镇痛中的应用效果良好,可减轻患者的术后疼痛程度,缩短患者术后康复进程,抑制炎症因子水平,降低应激反应水平,降低不良反应发生率。Objective To explore the application effect of knee joint catheterization analgesia technology in postoperative pain relief after knee arthroscopic surgery.Methods A total of 60 patients who underwent knee arthroscopic surgery in Ganzhou Hospital of TCM from January 2022 to June 2023 were selected as the research subjects,and they were divided into an experimental group and a control group according to random number table method,with 30 cases in each group.The control group received postoperative intravenous infusion of analgesic drugs for analgesic intervention,while the experimental group received postoperative intervention with knee joint catheterization analgesia technology.The postoperative analgesic effect,postoperative recovery time,serum inflammatory factors,stress response indicators,and incidence of adverse reactions between two groups were compared.Results The visual analogue scale(VAS)scores of the experimental group were lower than those of the control group at 6,12,24,and 36 h after surgery,with statistically significant differences(P<0.05).The time for getting out of bed,starting functional exercise,and hospitalization in the experimental group after surgery were shorter than those in the control group,with statistically significant differences(P<0.05).At 24 hours after surgery,the serum stress response indicators(norepinephrine[NE],epinephrine[E],and cortisol[Cor])in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).At 24 hours after surgery,the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and monocyte chemotactic protein-1(MCP-1)of the experimental group were lower than those of the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the experimental group was 6.67%(2/30),which was lower than 26.67%(8/30)of the control group,with a statistically significant difference(P<0.05).Conclusion The application of knee joint catheterization analgesia technology

关 键 词：膝关节镜手术 膝关节置管镇痛技术 镇痛效果 应激反应 炎症因子 

分 类 号：R614[医药卫生—麻醉学]