中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
35期
5620-5624
,共5页
植入物%人工假体%关节植入物%全膝关节置换%神经阻滞%置换后镇痛%膝关节功能%患者控制%麻醉诱导%目测类比评分%关节活动度%膝关节患者评分表
植入物%人工假體%關節植入物%全膝關節置換%神經阻滯%置換後鎮痛%膝關節功能%患者控製%痳醉誘導%目測類比評分%關節活動度%膝關節患者評分錶
식입물%인공가체%관절식입물%전슬관절치환%신경조체%치환후진통%슬관절공능%환자공제%마취유도%목측류비평분%관절활동도%슬관절환자평분표
Tissue Engineering%Knee Joint%Femoral Nerve
背景：全膝关节置换后剧烈疼痛是导致患者置换后膝关节功能恢复不佳的重要因素，如何给予患者置换后效果满意的镇痛方案是目前研究的热点。<br> 目的：观察不同镇痛方案对全膝关节置换患者置换后疼痛和功能恢复的影响。<br> 方法：将徐州市中心医院自2010年3月到2014年2月期间收治的60例单侧的膝关节置换患者随机分为3组：硬膜外镇痛组，静脉镇痛组，连续股神经阻滞镇痛组，每组各20例，均采用相应方法进行术后镇痛。记录并比较3组患者置换前、置换后不同状态下1，6，24，48，96 h的目测类比评分，置换后24，48，72 h关节活动度恢复情况；膝关节置换患者膝关节KSS评分；置换后出现的不良反应。<br> 结果与结论：与置换前比较，置换后1，24，48，96 h连续股神经阻滞镇痛组患者目测类比评分降低(P<0.05)。连续股神经阻滞镇痛组患者关节活动度恢复最好，其次为硬膜外镇痛组患者，静脉镇痛组恢复最差(P<0.05)；同置换前比较，3组患者置换后1，3个月膝关节功能KSS评分均升高(P<0.05)。同连续股神经阻滞镇痛组患者比较，置换后1，3个月硬膜外镇痛组，静脉镇痛组患者膝关节功能评分降低(P <0.05)。结果证实，连续股神经阻滞镇痛方案置换后总体效果较好，能够帮助患者更好的进行置换后关节功能恢复，安全可靠。
揹景：全膝關節置換後劇烈疼痛是導緻患者置換後膝關節功能恢複不佳的重要因素，如何給予患者置換後效果滿意的鎮痛方案是目前研究的熱點。<br> 目的：觀察不同鎮痛方案對全膝關節置換患者置換後疼痛和功能恢複的影響。<br> 方法：將徐州市中心醫院自2010年3月到2014年2月期間收治的60例單側的膝關節置換患者隨機分為3組：硬膜外鎮痛組，靜脈鎮痛組，連續股神經阻滯鎮痛組，每組各20例，均採用相應方法進行術後鎮痛。記錄併比較3組患者置換前、置換後不同狀態下1，6，24，48，96 h的目測類比評分，置換後24，48，72 h關節活動度恢複情況；膝關節置換患者膝關節KSS評分；置換後齣現的不良反應。<br> 結果與結論：與置換前比較，置換後1，24，48，96 h連續股神經阻滯鎮痛組患者目測類比評分降低(P<0.05)。連續股神經阻滯鎮痛組患者關節活動度恢複最好，其次為硬膜外鎮痛組患者，靜脈鎮痛組恢複最差(P<0.05)；同置換前比較，3組患者置換後1，3箇月膝關節功能KSS評分均升高(P<0.05)。同連續股神經阻滯鎮痛組患者比較，置換後1，3箇月硬膜外鎮痛組，靜脈鎮痛組患者膝關節功能評分降低(P <0.05)。結果證實，連續股神經阻滯鎮痛方案置換後總體效果較好，能夠幫助患者更好的進行置換後關節功能恢複，安全可靠。
배경：전슬관절치환후극렬동통시도치환자치환후슬관절공능회복불가적중요인소，여하급여환자치환후효과만의적진통방안시목전연구적열점。<br> 목적：관찰불동진통방안대전슬관절치환환자치환후동통화공능회복적영향。<br> 방법：장서주시중심의원자2010년3월도2014년2월기간수치적60례단측적슬관절치환환자수궤분위3조：경막외진통조，정맥진통조，련속고신경조체진통조，매조각20례，균채용상응방법진행술후진통。기록병비교3조환자치환전、치환후불동상태하1，6，24，48，96 h적목측류비평분，치환후24，48，72 h관절활동도회복정황；슬관절치환환자슬관절KSS평분；치환후출현적불량반응。<br> 결과여결론：여치환전비교，치환후1，24，48，96 h련속고신경조체진통조환자목측류비평분강저(P<0.05)。련속고신경조체진통조환자관절활동도회복최호，기차위경막외진통조환자，정맥진통조회복최차(P<0.05)；동치환전비교，3조환자치환후1，3개월슬관절공능KSS평분균승고(P<0.05)。동련속고신경조체진통조환자비교，치환후1，3개월경막외진통조，정맥진통조환자슬관절공능평분강저(P <0.05)。결과증실，련속고신경조체진통방안치환후총체효과교호，능구방조환자경호적진행치환후관절공능회복，안전가고。
BACKGROUND:Severe knee pain after total knee arthroplasty is an important factor for the poor recovery of knee function after replacement. How to give a satisfactory postoperative analgesia scheme is currently a hot research. OBJECTIVE:To explore the clinical effects of different analgesic program methods on postoperative pain and functional recovery in patients undergoing total knee arthroplasty. METHODS:From March 2010 to February 2014, 60 patients with unilateral knee arthroplasty were randomly divided into three groups:epidural analgesia group, intravenous analgesia group, and continuous femoral nerve block analgesia group. 20 patients in each group received corresponding postoperative analgesia. Visual Analogue Scale score before replacement, 1, 6, 24, 48 and 96 hours after replacement, the recovery of range of motion at 24, 48 and 72 hours after replacement, KSS score of the knee and adverse reactions after replacement were recorded and compared in each group. RESULTS AND CONCLUSION:Compared with the preoperative data, Visual Analogue Scale score was reduced in continuous femoral nerve block analgesia group at 1, 24, 48 and 96 hours after replacement (P<0.05). The recovery of range of motion was best in the continuous femoral nerve block analgesia group, fol owed by epidural analgesia group, and it was poorest in the intravenous analgesia group (P<0.05). Compared with the preoperative data, postoperative KSS scores increased at 1 and 3 months after replacement in the three groups (P<0.05). Compared with the continuous femoral nerve block analgesia group, knee joint function score was decreased in the intravenous analgesia group (P<0.05). Results verified that continuous femoral nerve block analgesia had good overal effects, helped the recovery of postoperative joint function, and was safe and reliable.
