[1]李晋玉 贾育松△ 徐林 孙旗 陈江 郑晨颖 白春晓 李丹毅.超前镇痛和鸡尾酒疗法对初次单侧TKA术后镇痛与 关节活动度改善的疗效评价[J].中国中医骨伤科杂志,2015,23(12):15-19.
　LI Jingyu JIA Yusong XU Lin SUN Qi CHEN Jiang ZHENG Chenying BAI Chunxiao LI Danyi.The Therapeutic Evaluation of Preemptive Analgesia and Cocktail Therapy Improving the Curative Effect of Postoperative Analgesia and Joint Mobility in Primary Unilateral TKA[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2015,23(12):15-19.
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超前镇痛和鸡尾酒疗法对初次单侧TKA术后镇痛与 关节活动度改善的疗效评价
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第23卷
期数:
2015年12期
页码:
15-19
栏目:
临床研究
出版日期:
2015-12-08

文章信息/Info

Title:
The Therapeutic Evaluation of Preemptive Analgesia and Cocktail Therapy Improving the Curative Effect of Postoperative Analgesia and Joint Mobility in Primary Unilateral TKA
文章编号:
1005-0205(2015)12-0015-05
作者:
李晋玉1 贾育松1△ 徐林1 孙旗1 陈江1 郑晨颖1 白春晓1 李丹毅1
1.北京中医药大学东直门医院骨1科(北京,100700)
△.通信作者 E-mail:jiays416@163.com
Author(s):
LI Jingyu1 JIA Yusong1△ XU Lin1 SUN Qi1 CHEN Jiang1 ZHENG Chenying1 BAI Chunxiao1 LI Danyi1
1.The 1st Department of Orthopedics,Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China.
关键词:
全膝关节置换术;  超前镇痛;  鸡尾酒疗法;  关节活动度
Keywords:
total knee arthroplasty;  preemptive analgesic;  cocktail therapy;  joint activity
分类号:
R684
文献标志码:
A
摘要:
目的:评价超前镇痛和鸡尾酒疗法在初次单侧全膝关节置换术(TKA)后镇痛与关节活动度改善的疗效。方法:筛选2013年1月至2014年12月在北京中医药大学东直门医院骨科行单侧TKA术的患者共45例。其中,A组术前及活动前口服塞来昔布胶囊进行超前镇痛,术中关节周围注射鸡尾酒混合液镇痛,术后应用自控静脉镇痛泵; B组术前及活动前口服塞来昔布胶囊和盐酸曲马多缓释片进行超前镇痛,结合术中关节周围注射鸡尾酒混合液镇痛; C组术后单独应用自控静脉镇痛泵。分析围术期患者静息和活动状态下视觉模拟疼痛评分(VAS)及膝关节屈伸活动度(ROM)评分,比较三组术后镇痛效果和关节活动度改善状况。结果:静息痛评分术后6,12,24,36 h A组与B组分数均显著低于C组(P<0.01),术后6,12,24 h A组患者改善分数低于B组(P<0.01)。活动痛评分术后6,12,24,36,48,72 h患者改善分数比较,A组<B组<C组(P<0.01)。膝关节活动度术后24,48,72 h评分,A组>B组>C组,差异有统计学意义(P<0.01),术后7 d三组运动状态的VAS评分及屈伸活动范围差异无统计学意义(P>0.05)。结论:超前镇痛和鸡尾酒疗法对缓解初次单侧全膝关节置换术后疼痛和改善关节活动度具有积极作用,可以有效降低术后早期静息和活动状态VAS评分,提高关节活动度评分,且术后并发症少,有利于提高患者满意度,促进关节功能的早期康复。
Abstract:
Objective:To evaluate the efficacy of preemptive analgesia and cocktail therapy for the improvement of pain and joint activity after initial unilateral total knee arthroplasty.Methods:45 cases undergoing primary unilateral total knee replacement patients in accordance with the table of random numbers were randomly divided into three groups,15 cases in each group.Group A took celecoxib capsules before surgery and activity for preemptive analgesia,and was injected with a mixture of the joint around the joint in operation,and then self-controlled venous analgesia pump was used after surgery.Group B took celecoxib capsules and tramadol hydrochloride sustained-release tablets before surgery and activity for preemptive analgesia,and was injected with a mixture of the joint around the joint in operation.Self-controlled venous analgesia pump was only used in group C after surgery.The perioperative VSA and ROM in resting and active state were analyzed to compare the postoperative analgesia effect and the ameliorations of joint mobility.Results:The resting VAS of group A and B are significantly lower than that of group C at 6 h,12 h,24 h and 36 h after surgery(P<0.01).The patients' improved VAS of group A is lower than that of group B at 6 h,12 h and 24 h after surgery(P<0.01).As for the improved VAS in active state,group A<group B<group C at 6 h,12 h,24 h,36 h,48 h,and 72 h after surgery(P<0.01).As for the scores of ROM,group A > group B > group C at 24 h,48 h and 72 h after surgery,and there was significant difference(P<0.01).The 3 sets' VAS in active state and ROM have no statistical difference(P>0.05).There was no significant difference in the VAS score and the range of flexion and extension for 3 groups 7 days after operation.Conclusion:Preemptive analgesia and cocktail therapy can relieve pain and improve joint activity after initial unilateral total knee arthroplasty.It can effectively reduce the VAS score of early resting and active state,improve joint activity score,and postoperative complications are less,it is beneficial to increase patient satisfaction,and promote early recovery of joint function.

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备注/Memo

备注/Memo:
收稿日期:2015-08-03
基金项目:国家自然科学基金项目(81503601)
北京市 “十病十药”研发专项课题
更新日期/Last Update: 2015-12-15