摘要目的 探讨超声引导下连续隐神经置管阻滞在膝关节置换术后的应用价值。方法 选取2017年7月～2019年7月我院收治的80例椎管内麻醉下行膝关节置换术的患者作为研究对象，根据随机数字表法分为对照组与观察组，每组各40例。对照组患者实施静脉持续自控镇痛，观察组患者则应用超声引导下连续隐神经置管阻滞。比较两组患者术后不同时间点的疼痛评分、术后下床时间、术后48 h 膝关节活动度、术后住院时间以及恶心呕吐、头晕、尿潴留、下肢肌力降低等并发症的发生率。结果 观察组患者术后12、24 及48 h 的疼痛评分均低于对照组，差异有统计学意义（P＜0.05）；观察组患者术后下床时间早于对照组，术后48 h 膝关节活动度大于对照组，术后住院时间短于对照组，差异均有统计学意义（P＜0.05）；观察组患者术后48 h 的并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。结论 膝关节置换术患者实施超声引导下连续隐神经置管阻滞镇痛，能够有效减轻术后疼痛，促进早期下床及关节功能恢复，且并发症少，安全性高。
Abstract：Objective To explore the application value of ultrasound-guided continuous saphenous nerve catheterization block after knee arthroplasty.Methods A total of 80 csaes with knee arthroplasty under spinal anesthesia from July 2017 to July 2019 treated in our hospital were selected.According to the random number table method,they were divided into control group and observation group, with 40 cases in each group.The control group received intravenous continuous patient-controlled analgesia, and the observation group received ultrasound-guided continuous saphenous nerve block analgesia.The pain score at different time points after operation, the time of getting out of bed after operation,the knee joint activity 48 h after operation, the hospitalization time after operation, and the incidence rate of nausea,vomiting, dizziness, urinary retention and lower limb muscle strength reduction were compared between the two groups.Results The pain scores in the observation group at 12, 24 and 48 h after operation were lower than those in the control group, the differences were statistically significant (P＜0.05).The ambulation time in the observation group after operation was earlier than that in the control group, the knee joint activity at 48 h after operation was greater than that in the control group, the hospitalization time after operation was shorter than that in the control group, the differences were statistically significant (P＜0.05).The total incidence of complications in the observation group at 48 h after operation were lower than control group, the difference was statistically significant (P＜0.05).Conclusion For patients undergoing knee arthroplasty, ultrasound-guided continuous saphenous nerve catheterization block analgesia can effectively reduce postoperative pain and promote early recovery of bed and joint function,with fewer complications and high safety.
京公网安备 11010502046607号