肩关节置管镇痛技术在肩关节镜手术后镇痛中的应用效果  

Application Effect of Catheterization Analgesia Technique of Shoulder Joint in Analgesia after Shoulder Arthroscopic Surgery

作　　者：黄金 赖建鸿 彭福英 林鹰 曾凡英 李兵 HUANG Jin;LAI Jianhong;PENG Fuying;LIN Ying;ZENG Fanying;LI Bing(Department of Anesthesiology,Ganzhou Hospital of Traditional Chinese Medicine,Ganzhou 341000,China;不详)

机构地区：[1]赣州市中医院麻醉科,江西赣州341000 [2]赣州市人民医院耳鼻喉科,江西赣州341000

出　　处：《中国医学创新》2024年第25期25-29,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划课题(SKJP220226943)。

摘　　要：目的:分析肩关节置管镇痛技术在肩关节镜手术后镇痛中的应用效果。方法:选取2023年1—12月赣州市中医院收治的60例行肩关节镜手术治疗患者,通过红蓝摸球法随机分为对照组和试验组,各30例。对照组应用自控静脉镇痛干预,试验组应用肩关节置管镇痛技术。比较两组镇痛效果、康复指标、致痛物质水平、炎症因子水平和不良反应发生情况。结果:与对照组相比,试验组术后4、8、12、24、48 h视觉模拟评分法(VAS)评分均低,实际按压静脉镇痛泵和补救镇痛次数均少,差异均有统计学意义(P<0.05)。与对照组相比,试验组功能锻炼开始时间早,术后住院天数短,镇痛满意度高,差异均有统计学意义(P<0.05)。术后4、12、24 h,试验组较对照组的P物质(SP)、神经肽(NPY)、5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))、缓激肽(BK)水平均低,差异均有统计学意义(P<0.05)。术后4、12、24 h,试验组较对照组的白细胞介素-6(IL-6)、单核细胞趋化因子蛋白-1(MCP-1)、高迁移率族蛋白-1(HMGB-1)、肿瘤坏死因子-α(TNF-α)水平均低,差异均有统计学意义(P<0.05)。对照组和试验组不良反应发生率分别为10.00%和6.67%,差异无统计学意义(P>0.05)。结论:在肩关节镜手术后镇痛中应用肩关节置管镇痛技术进行干预,显著改善术后镇痛效果,降低致痛物质水平、炎症因子水平,促进患者康复,且安全性较高。Objective:To analyze the application effect of shoulder joint catheterization analgesia technique in analgesia after shoulder arthroscopic surgery.Method:A total of sixty patients with shoulder arthroscopic surgery admitted to Ganzhou Hospital of Traditional Chinese Medicine from January to December 2023 were selected,and they were randomly divided into control group and experimental group by red and blue touch the ball method,with 30 cases in each group.The control group was treated with self-controlled intravenous analgesia,and the experimental group was treated with shoulder joint catheterization analgesia.The analgesic effects,rehabilitation indexes,levels of algogenic substances,levels of inflammatory factors and occurrence of adverse reactions were compared between two groups.Result:Compared with the control group,the visual analogue scale(VAS)scores at 4,8,12,24 and 48 h after surgery in the experimental group were lower,and the actual times of intravenous analgesia pump and relief analgesia were less,the differences were statistically significant(P<0.05).Compared with the control group,the start time of functional exercise was earlier and hospitalization days after operation of experimental group was shorter,and the satisfaction of analgesia was higher,the differences were statistically significant(P<0.05).At 4,12 and 24 h after surgery,the levels of substance P(SP),neuropeptide Y(NPY),5-hydroxytryptamine(5-HT),prostaglandin-2(PGE_(2))and bradykinin(BK)in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).At 4,12 and 24 h after surgery,the levels of interleukin-6(IL-6),monocyte chemotactic protein-1(MCP-1),high mobility group protein B-1(HMGB-1)and tumor necrosis factor-α(TNF-α)in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in control group and experimental group was 10.00%and 6.67%,respectively,the difference was not statistically signific

关 键 词：肩关节置管镇痛技术 肩关节镜手术 镇痛 致痛物质 

分 类 号：R614[医药卫生—麻醉学] R687.4[医药卫生—外科学]