多模式镇痛在全膝关节置换术中的临床疗效及对应激反应
的影响
蔡炜;唐旭东;陈捷;王贵胜
【期刊名称】《四川医学》 【年(卷),期】2015(000)003
【摘要】目的：探讨多模式镇痛在全膝关节置换术中的镇痛效果及其对术后应激反应的影响，减轻术后疼痛。方法选择符合标准的患者60例，随机分为观察组和对照组各30例，观察组应用多模式镇痛，对照组应用静脉泵镇痛，比较术后视觉模拟评分法(VAS)评分、血浆C-反应蛋白(CRP)、白介素-6(IL-6)水平、术后活动时间。结果观察组患者术后1 h、6 h、24 h、48 h和CPM训练30 min的VAS评分均低于对照组，差异有统计学意义(P<0.05)。两组患者术前血浆CRP及IL-6水平比较，差异无统计学意义(P>0.05)；术后两组患者血浆CRP及IL-6水平较术前均升高差异有统计学意义(P<0.05)，但是对照组升高幅度较观察组更大，差异有统计学意义(P<0.05)。观察组患者第1次下床活动时间和膝关节主动屈膝90°时间均短于对照组，差异有统计学意义(P<0.05)。结论多模式镇痛能有效缓解全膝关节置换术患者术后疼痛，减轻术后应激反应，有利于术后早期康复训练。%Objective To investigate the analgesia effect of multimodal analgesia in the total knee replacement and its in-fluence on stress response so as to reduce the postoperative pain. Methods 60 patients meeting the standard were selected and randomly divided into the observation group(n=30)and the control group(n=30). The observation group was given multimodal analgesia, while the control
group was given controlled intravenous analgesia. The two groups were compared with the postoperative visual analogue scale(VAS)score, plasma C - reactive protein(CRP)and interleukin-6(IL-6)level, and postoperative activity time. Results VAS scores at postoperative 1 h, 6 h, 24 h, 48 h and 30 min trained by CPM were lower in the observation group than that of the control group, and the difference was statistically significant(P<0. 05). Preoperative plasma CRP and IL-6 of the two groups were compared, and there was no statistically significant difference(P>0. 05);Postoperative plasma CRP and IL-6 of the two groups were increased compared to the preoperative values(P<0. 05), but the elevated amplitude in the control group was larger than that of the observation group, and the difference was statistically significant(P<0. 05). For the first time, the activity time and the time for the knee to be bent at 90° were shorter in the observation group than that of the control group, and the differ-ence was statistically significant(P<0. 05). Conclusion Multimodal analgesia can effectively alleviate postoperative pain in pa-tients with total knee replacement, and reduce the postoperative stress response, which is beneficial to early postoperative rehabili-tation training. 【总页数】3页(371-373)
【关键词】全膝关节置换术;多模式镇痛;手术镇痛;应激反应 【作者】蔡炜;唐旭东;陈捷;王贵胜
【作者单位】内江市第一人民医院骨科，四川 内江641000;内江市第一人民医院骨科，四川 内江641000;内江市第一人民医院骨科，四川 内江641000;内江市第一人民医院骨科，四川 内江641000 【正文语种】中文 【中图分类】R687.4 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_sichuan-medical-journal_thesis/0201249660345.html 【相关文献】
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多模式镇痛在全膝关节置换术中的临床疗效及对应激反应的影响
