联合鸡尾酒疗法与收肌管阻滞对单髁膝关节置换术后镇痛效果的评价

基础医学与临床 ›› 2021, Vol. 41 ›› Issue (11): 1648-1652.

联合鸡尾酒疗法与收肌管阻滞对单髁膝关节置换术后镇痛效果的评价

张浩沙强^1#, 嵇莎莎^1#, 王志刚^1*, 田野²

1.新疆维吾尔自治区人民医院关节运动科,新疆乌鲁木齐 830002;
2.中国医学科学院北京协和医学院北京协和医院骨科,北京 100730

收稿日期:2020-08-24 修回日期:2020-12-21 发布日期:2021-10-27
通讯作者: *1320186635@qq.com
作者简介:^#对本文有相同贡献

Evaluation of analgesic effect of cocktail therapy combined with adductor block on patients undergoing unicompartmental knee arthroplasty

ZHANG Hao-sha-qiang^1#, JI Sha-sha^1#, WANG Zhi-gang^1*, TIAN Ye²

1. Department of Joint and Sports Medicine, People's Hospital of the Xinjiang Uygur Autonomous Region, Urumqi 830002;
2. Department of Orthopaedics, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730,China

Received:2020-08-24 Revised:2020-12-21 Published:2021-10-27
Contact: *1320186635@qq.com

摘要/Abstract

摘要： 目的应用不同方法控制围手术期疼痛,分析用于单髁膝关节置换(UKA)治疗前内侧膝骨关节炎患者的结果,评价其临床效果及安全性。方法分析新疆维吾尔自治区人民医院骨科,2017年1月至2019年12月应用单髁人工膝关节置换术治疗后的内侧单间室膝骨关节炎患者的治疗效果;其中男性18例,女性27例,平均年龄为(63.41±1.19)岁;根据术中不同的镇痛方法分为3组,每组15例;A组患者使用鸡尾酒疗法行关节囊内及两侧副韧带区局部注射;B组患者使用超声引导下患侧收肌管阻滞麻醉;C组联合鸡尾酒疗法与收肌管阻滞。根据随访的结果,分析VAS评分、KSS评分、直腿抬高时间、下地时间的差别。结果 3组患者术前VAS评分、KSS评分差别无统计学意义,具有同质性,但治疗后比治疗前改变明显(P＜0.05);3组术后组间比较存在差异(P＜0.05)。结论 UKA能确切缓解患者疼痛症状和活动受限的体征,最大限度的保留膝关节非病损部分,是保膝治疗的有效手术方法。联合鸡尾酒疗法与收肌管阻滞能最大限度的缓解围手术期疼痛,增加患者功能康复的效果。

关键词: 关节成形术, 单髁, 镇痛, 鸡尾酒疗法

Abstract: Objective To analyze the results of unicompartmental knee arthroplasty (UKA) in patients with single compartment of knee osteoarthritis, and to evaluate the clinical outcomes and safety with different analgesias. Methods Totally 45 cases were recruited from January 2017 to December 2019 including 18 males and 27 females. The mean age was (63.41±1.19) year-old. They were divided into three groups with 15 in each.Patients in group A received cocktail treatment after surgery. Patients in group B received adductor canal blockade treatment by ultrasound guide after surgery. and those in group C received both cocktail treatment and adductor canal blockade treatment by ultrasound guide after surgery. VAS score and KSS score were compared and analyzed according to postoperative follow-up results. Results VAS scores and KSS scores of the three groups before surgery were not different but VAS scores and KSS scores of the two groups were significantly reduced after treatment (P＜0.05). Post-operative VAS score and KSS score were significantly different between the two groups (P＜0.05). Conclusions As an effective final treatment for single compartment of knee osteoarthritis, UKA is the most effective treatment in the early and middle stages of knee preserving surgery. Combining cocktail treatment and adductor canal blockade treatment by ultrasound guide after surgery can provide a safe post-operative analgesia for unicompartmental knee arthroplasty.

Key words: arthroplasty, unicompartment, analgesia, cocktail therapy

中图分类号:

R684.3

张浩沙强, 嵇莎莎, 王志刚, 田野. 联合鸡尾酒疗法与收肌管阻滞对单髁膝关节置换术后镇痛效果的评价[J]. 基础医学与临床, 2021, 41(11): 1648-1652.

ZHANG Hao-sha-qiang, JI Sha-sha, WANG Zhi-gang, TIAN Ye. Evaluation of analgesic effect of cocktail therapy combined with adductor block on patients undergoing unicompartmental knee arthroplasty[J]. Basic & Clinical Medicine, 2021, 41(11): 1648-1652.

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