[1]陈 壁,李剑钢,沈国灿,等.股神经阻滞与股收肌管阻滞在TKA术后 患者跌倒的临床观察[J].医学信息,2019,32(12):99-101.[doi:10.3969/j.issn.1006-1959.2019.12.030]
　CHEN Bi,LI Jian-gang,SHEN Guo-can,et al.Clinical Observation of Femoral Nerve Block and Femoral Muscle Block in Patients with Fall after TKA[J].Journal of Medical Information,2019,32(12):99-101.[doi:10.3969/j.issn.1006-1959.2019.12.030]
点击复制

股神经阻滞与股收肌管阻滞在TKA术后 患者跌倒的临床观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年12期
页码:
99-101
栏目:
临床研究
出版日期:
2019-06-15

文章信息/Info

Title:
Clinical Observation of Femoral Nerve Block and Femoral Muscle Block in Patients with Fall after TKA
文章编号:
1006-1959（2019）12-0099-03
作者:
陈 壁; 李剑钢; 沈国灿; 桂 琳
云南省曲靖市第一人民医院麻醉科，云南 曲靖 655000
Author(s):
CHEN Bi; LI Jian-gang; SHEN Guo-can; GUI Lin
Department of Anesthesiology,the First People's Hospital of Qujing City,Qujing 655000,Yunnan,China
关键词:
TKA; 术后跌倒; 连续股神经阻滞; 连续股收肌管阻滞
Keywords:
Key words：TKA; Postoperative fall; Continuous femoral nerve block; Continuous femoral muscle block
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2019.12.030
文献标志码:
A
摘要:
目的 探究连续股神经阻滞与连续股收肌管阻滞在TKA术后患者跌倒中的应用价值。方法 选取我院2015年7月~2018年6月收治的84例行TKA术治疗的患者作为研究对象，随机分为参照组和研究组，每组42例。参照组实施连续股神经阻滞，研究组实施连续股收肌管阻滞，比较两组治疗前后静息痛和活动痛VAS评分、各时间点股四头肌肌力和关节活动度情况。结果治疗前，参照组和研究组的静息痛VAS评分、活动痛VAS评分比较，差异无统计学意义（P＞0.05）；治疗后，研究组的静息痛VAS评分、活动痛VAS评分低于参照组，但差异无统计学意义（P＞0.05）；治疗24 h和48 h后，研究组的股四头肌肌力和关节活动度均优于参照组，差异有统计学意义（P＜0.05）；治疗72 h后，两组的股四头肌肌力比较，差异无统计学意义（P＞0.05），关节活动度比较，差异有统计学意义（P＜0.05）。结论 针对TKA术后患者跌倒现象，实施连续骨神经组织和连续股收肌管组织的效果均比较理想，但连续股收肌管阻滞在股四头肌肌力和膝关节活动度的改善方面作用更大，更加适合应用在治疗中。
Abstract:
Abstract：Objective To investigate the value of continuous femoral nerve block and continuous femoral muscle block in the fall of patients after TKA. Methods Selected 84 patients who underwent TKA in our hospital from July 2015 to June 2018 were enrolled in the study. They were randomly divided into a reference group and a study group, with 42 cases in each group. The study group underwent continuous femoral nerve block. The study group performed continuous femoral muscle block, and compared the VAS scores of resting pain and active pain before and after treatment, and the muscle strength and joint mobility of the quadriceps at each time point. Results Before treatment, the VAS scores of the resting group and the VAS scores of the active pain in the reference group and the study group were not significantly different (P>0.05). After treatment, the VAS score and VAS score of resting pain in the study group were lower than the reference group, but the difference was not statistically significant (P>0.05). After 24 h and 48 h of treatment, the quadriceps muscle strength of the study group The joint mobility was better than that of the reference group,the difference was statistically significant (P<0.05). After 72 h of treatment, there was no significant difference in the quadriceps muscle strength between the two groups (P>0.05); the difference in joint mobility was statistically significant (P<0.05).Conclusion The effect of continuous skeletal nerve tissue and continuous femoral duct tissue is satisfactory for patients with TKA after fall, but continuous femoral muscle block is in the improvement of quadriceps muscle strength and knee joint mobility. It has a greater effect and is more suitable for use in therapy.

参考文献/References:

[1]孔宪刚,宋成伟,侯代亮,等.连续收肌管阻滞和连续股神经阻滞对膝关节置换术患者术后镇痛和早期功能康复的影响[J].国际麻醉学与复苏杂志,2017,38(7):2561-2562. [2]王红珠,丁进峰,王明仓.收肌管阻滞与股神经阻滞用于膝关节镜手术的比较[J].浙江医学,2016,38(4):282-284. [3]雷光磊,张兰,姚富,等.超声引导下连续股神经阻滞与连续收肌管阻滞在膝关节置换术后镇痛中的应用比较[J].医学临床研究,2018,35(1):37-40. [4]张云慧,岳冬梅,刘清仁,等.持续收肌管阻滞对全膝关节置换术后早期活动的影响[J].临床麻醉学杂志,2015,31(10):966-968. [5]丁煌,周妙苗,崔珊珊,等.收肌管阻滞联合浸润麻醉用于全膝关节置换患者术后镇痛的效果[J].中华麻醉学杂志,2016,36(9):1102-1105. [6]车璐,唐帅,黄宇光.膝关节置换术的围术期区域镇痛方式选择[J].基础医学与临床,2017,37(4):567-570. [7]谭振,康鹏德,裴福兴,等.多模式镇痛下收肌管与股神经阻滞在全膝关节置换术后初期镇痛及早期康复中的作用[J].中华骨科杂志,2015,35(9):914-920. [8]孔宪刚,李海鸥,宋成军,等.超声引导下收肌管阻滞在全膝关节置换术后多模式联合镇痛中的作用[J].山东医药,2017,57(21):58-61. [9]杨舜敏.膝关节置换术后连续ACB或FNB镇痛对疼痛及早期功能训练的影响[J].医学临床研究,2017,34(5):1478-1479. [10]程序,郑琳莉,徐毅,等.股神经阻滞用于全膝关节置换术术后镇痛有效性的系统评价再评价[J].中国循证医学杂志,2017, 12(3):283-290. [11]于国军,杨富林,陆化梅.股神经阻滞和收肌管阻滞对全膝关节置换术后镇痛及关节功能的影响[J].广东医学,2017,38(7):1075-1077. [12]蒋秋香,张正迪,邓斌,等.不同镇痛方法对膝关节置换术后疼痛和早期康复的影响[J].中国矫形外科杂志,2018,12(3):198-202. [13]赵旻暐,田华,王宁.连续收肌管阻滞在全膝关节置换术后镇痛方面的应用[J].中国微创外科杂志,2016,16(12):1146-1149. [14]刘妮,王晋平,王榆富,等.超声引导下收肌管阻滞在全膝关节置换术后的应用[J].中国药物与临床,2017,17(8):1200-1202. [15]辛玲,冯艺.收肌管阻滞用于全膝关节置换术后镇痛的研究进展[J].临床麻醉学杂志,2016,32(6):613-615. [16]李灿锋,徐宏伟,沈彬,等.置管持续收肌管阻滞与单次注射收肌管阻滞对人工全膝关节置换术后镇痛及早期康复的影响研究[J].中国修复重建外科杂志,2017,20(9):1049-1054.

相似文献/References:

[1]徐 谦,赵 枫,程兴旺,等.PCL在TKA中保留程度及可行性研究[J].医学信息,2019,32(21):52.[doi:10.3969/j.issn.1006-1959.2019.21.018]
　XU Qian,ZHAO Feng,CHENG Xing-wang,et al.Study on the Degree of Retention and Feasibility of PCL in TKA[J].Journal of Medical Information,2019,32(12):52.[doi:10.3969/j.issn.1006-1959.2019.21.018]

更新日期/Last Update: 2019-06-15