摘要
目的:研究全膝关节置换术后两种不同方式“鸡尾酒”注射的镇痛效果。方法:选取2018年7至9月因单侧膝关节骨性关节炎行单侧人工全膝关节表面置换术的患者50例,其中25例安装假体前行前方股四头肌以及内外侧副韧带周围“鸡尾酒”注射,25例行后方关节囊周围“鸡尾酒”注射。比较两组患者术后第6,12,24,48,72小时静态和动态的疼痛视觉模拟评分(Visual Analogue Scale,VAS),术后第48,72小时膝关节最大屈曲度,直腿抬高的时间,患者自控镇痛泵使用率,不良反应发生率。结果:前方“鸡尾酒”注射组术后第6,12,24小时静态VAS评分,以及术后第6,12小时动态VAS评分低于后方注射组(均P<0.05)。与“鸡尾酒”后方注射组比较,前方注射组第48,72小时的膝关节最大屈曲度增大更明显(均P<0.05)。与“鸡尾酒”后方注射组比较,前方注射组术后直腿抬高时间明显缩短(P=0.027)。结论:前方注射“鸡尾酒”对全膝关节置换术后早期疼痛具有更好的镇痛效果,能改善膝关节功能,有良好的安全性,是一种优良的“鸡尾酒”注射方式。
Objective:To evaluate the efficacy of different ways of cocktail analgesic mixture injection on total knee arthroplasty(TKA).Methods:A total of 50 patients with knee osteoarthritis treated by TKA from July to September 2018 were randomly divided into two groups(n=25).The Group 1 underwent anterior intra-articular injection before prosthesis implanted while the Group 2 underwent posterior intra-articular injection before prosthesis implanted.Visual Analogue Scale(VAS)of all patients for pain during activity and at rest,maximal flexion degree of the knee at the 48th h and the 72th h after surgery,the time of raise leg,usage rate of patient-controlled analgesia(PCA),and complications were evaluated and analyzed.Results:VAS for pain at rest of patients in the Group 1 was significantly less than that in the Group 2 at the 6th,12th,and 24th h after surgery(all P<0.05).Maximal flexion degree of the knee at the 48th h and the 72th h after surgery in the Group 1 was better than that in the Group 2(both P<0.05).The Group 1 costed less time than the Group 2 on the ability to perform an active straight leg raise(P=0.027).Conclusion:The anterior intra-articular cocktail analgesic mixture injection can strongly relieve the pain early after TKA,which can improve knee function and achieve painless rehabilitation in most patients,with safety.
作者
李科伟
侯颖周
王少华
黎志宏
LI Kewei;HOU Yingzhou;WANG Shaohua;LI Zhihong(Second Department of Joint Disease,Zhengzhou Orthopedics Hospital,Zhengzhou 450052;Department of Orthopedics,Second Xiangya Hospital,Central South University,Changsha 410011,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2020年第4期406-410,共5页
Journal of Central South University ：Medical Science
关键词
“鸡尾酒”疗法
前方注射
后方注射
人工全膝关节置换
镇痛
cocktail therapy
anterior intra-articular injection
posterior intra-articular injection
total knee arthroplasty
analgesia
