全膝人工关节置换术围手术期联合镇痛的探讨

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1、万方数据全膝人工关节置换术围手术期联合镇痛的探讨摘要目的：探讨膝关节置换术围手术期的早期有效的镇痛方法。方法：年龄在55—70岁之间的双膝重度骨性关节炎患者40例，拟行双侧全膝关节置换术。采用随机的方法将40例分为两组，A组：先行单侧膝关节置换术，术前服用“双氯芬酸钠双释放缓释胶囊”，术中膝关节周围软组织(膝关节后关节囊和内、外侧副韧带起止点，股四头肌伸肌装置和髌韧带组织以及膝关节周围滑膜组织)行局部注射镇痛药“鸡尾酒”。B组：上述40例病人在康复1月左右，行对侧膝关节置换术，术前服用“双氯芬酸钠双释放缓释胶囊”，术后

2、给予病人静脉自控镇痛(PCIA)；于患者术后2天内记录每个时间点休息时疼痛VAS评分：患者满意度和24小时的术后疼痛程度及副作用：检测血红蛋白(Hb)、D一二聚体等指标变化，创口引流量：患者术后3天内的主动活动度。结果：A组术后2天内的疼痛VAS评分明显比B组低，差异有统计学意义(P0．05)。两组术后创口引流量及手术前后血红蛋白(Hb)及血小板(plt)变化量、血浆D一

3、二聚体变化差异无统计学意义(P>O．05)。A组术后出现恶心、呕吐、尿储留等副作用几率比B组低，差异也有统计学意义(P

4、组织胚胎学)指导教师夏玉军教授关键词：全膝置换术联合镇痛围手术期万方数据lUlllUllIIIlllllllIIIJUlY2738633CombinedanalgesiafortotalkneearthroplastyinperioperativeAbstractobjfective：Toexploretheearlyeffectiveanalgesicmethodsforperioperativeoftotalkneearthroplasty(TKA)．Methods：40patientswithbilateralk

5、neesevereosteoarthritisweretreatedwithTKA，withanaverageageof63years(range，55to70years)．Accordingtotheorderofoperation，thepatientsweredividedintotwogroups．ThesidesoffirstoperationweregroupA．a11patientstaking‘‘DiclofenacSodiumDoubleReleaseSustained，releaseCapsules

6、’’inthepreoperativeandinjectingpainreliever“cocktail”intothesofttissuearoundthekneejoint(includeAfterkneejointcapsule，theload-pointofMedialCollateralLigamentandLateralCollateralLigament，Quadricepsextensordevice，PatellartendonandSynovialtissueofkneejoint)intraope

7、ritve．ThesidesofsecondoperationweregroupBwhenmakingrehabilitationtrainingonemonth，allpatientstaking“DiclofenacSodiumDoubleReleaseSustained—releaseCapsules”inthepreoperativeandmakingPCIAtoeasethepainafteroperation．Thepainintensityforpatientswasmeasuredwithvisuala

8、naloguescale(VAS)．Recordingthepainscoreinthetwodays，thedegreeofthesatisfaction，thedegreeofthepaininthefirst24hours，thesideeffects，thebloodlossandtheactiverangeofkneei