“鸡尾酒”疗法在人工全膝关节置换术后早期疼痛的疗效分析

尚振+王英振

[摘要] 目的 探讨“鸡尾酒”疗法在人工全膝关节置换术后早期疼痛的疗效。方法 方便选择2016年1—12月于该院行TKA治疗的61例患者作为研究对象，將其分为研究组31例与对照组30例。对照组在常规镇痛措施，研究组在此基础上应用“鸡尾酒”疗法。 结果 研究组术后静息状态下，6、12、24、48 h时VAS评分为（5.77±1.055）分、（4.58±1.025）分、（3.48±0.811）分、（2.42±0.765）分，低于对照组（7.90±0.960）分、（6.63±1.033）分、（5.43±0.898）分、（4.37±0.928）分（P<0.05）；研究组术后活动状态下，24、48 h时VAS评分（5.65±0.985）分、（4.26±0.930）分，低于对照组（7.57±1.104）分、（6.23±1.104）分（P<0.05）；研究组术后不良反应发生率6.45%与对照组10.00%对比，差异无统计学意义（P>0.05）。结论 “鸡尾酒”疗法在TKA术后早期疼痛中具有显著的应用效果。

[关键词] 鸡尾酒疗法；人工全膝关节置换术；术后；早期疼痛

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）02（c）-0027-03

Analysis of Curative Effect of Cocktail Therapy in the Early Pains after the Total Knee Arthroplasty

SHANG Zhen， WANG Ying-zhen

Department of Joint Surgery， Affiliated Hospital of Qingdao University， Qingdao， Shandong Province， 266000 China

[Abstract] Objective To discuss the curative effect of cocktail therapy in the early pains after the total knee arthroplasty. Methods Convenient selection 61 cases of patients with TKA treatment in our hospital from January to December 2016 were selected as the research objects and divided into two groups， the control group with 31 cases adopted the routine analgesia measures， while the research group adopted the cocktail therapy on the basis of the control group. Results The VAS scores at 6，12， 24 and 48 h in the postoperative quiescent condition in the research group were lower than those in the control group，[（5.77±1.055）marks， （4.58±1.025）marks，（3.48±0.811）marks，（2.42±0.765）marks vs （7.90±0.960）marks， （6.63±1.033）marks， （5.43±0.898）marks，（4.37±0.928）marks]， and the VAS scores at 24h and 48h in the postoperative activity condition in the research group were lower than those in the control group， [（5.65±0.985）marks， （4.26±0.930）marks vs （7.57±1.104）marks， （6.23±1.104）marks]（P<0.05）， and the incidence rate of postoperative adverse reactions in the research group was lower than that in the control group（6.45% vs 10.00%） and the difference had no statistical significance（P>0.05）. Conclusion The application effect of cocktail therapy in the early pains after the total knee arthroplasty is obvious.

[Key words] Cocktail therapy； Total knee arthroplasty； After operation； Early pain

人工全膝关节置换术（ total knee arthroplasty，TKA）是治疗晚期膝关节疾病的主要方法，现已在临床得到了广泛的应用。研究发现，早期功能锻炼是保证TKA预后效果，促使关节功能康复的关键[1]。然而，TKA后易发生疼痛，这在一定程度上限制了TKA的早期功能锻炼效果，且易导致感染、深静脉血栓等并发症。因此，采取有效的措施改善TKA术后疼痛症状十分必要。2016年1—12月，该院对31例行TKA手术的患者应用了“鸡尾酒”镇痛疗法，收效满意，现报道如下。

1 资料与方法

1.1 一般资料

方便选择于该院行TKA治疗的61例患者作为研究对象，将其随机分为两组，即研究组31例与对照组30例。入组标准：ASA分级为I～II级；腰硬联合麻醉下初次行單侧TKA；患者对该次研究内容知情。排除标准：合并严重心脏血管疾病或（和）脏器功能障碍；中枢性或精神类疾病史；局麻药物过敏史；免疫系统疾病史；长期应用激素或镇痛药物史。研究组：男12例，女19例；年龄56～77岁（66.61±5.500） 岁。对照组：男13例，女17例；年龄57～76岁（ 66.60±4.903）岁。……