三种不同镇痛技术用于全膝关节置换术术后的镇痛效果比较.docVIP

三种不同镇痛技术用于全膝关节置换术术后的镇痛效果比较 　　[摘要] 目的 比?^患者静脉自控镇痛（PCIA）、患者硬膜外自控镇痛（PCEA）和连续股神经阻滞（CFNB）3种镇痛技术用于全膝关节置换术（TKA）术后镇痛效果及不良反应。 方法 根据相应纳入标准回顾性收集2010年1月～2016年8月温州医科大学附属第二医院TKA患者，依据术后镇痛方式的不同分为PCIA、PCEA和CFNB三组，再随机从每组中各抽取80例患者。记录三组患者术后随访的VAS评分及不良反应等情况。 结果 三组一般资料比较，差异均无统计学意义（P 0.05）。镇痛效果比较：静息状态和活动状态下三组各时点VAS评分差异均有高度统计学意义（P 　　[关键词] 全膝关节置换术；患者自控镇痛；连续股神经阻滞；疼痛评分 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2017）05（a）-0069-04 　　Comparison of three postoperative analgesia for total knee arthroplasty 　　YANG Zhuqing1 ZHANG Rui2 ZHUO Changshu1 LIAN Qingquan1 DI Meiqing1 　　1.Department of Anesthesiology， the Second Affiliated Hospital of Wenzhou Medical University， Zhejiang Province， Wenzhou 325027， China； 2.Department of Orthopaedic， the Second Affiliated Hospital of Wenzhou Medical University， Zhejiang Province， Wenzhou 325027， China 　　[Abstract] Objective To compare analgesia effects and adverse events among patient-controlled intravaneous analgesia （PCIA）， patient-controlled epidural analgesia （PCEA） and continuous peripheral nerve block （CPNB） after total knee arthroplasty （TKA）. Methods Patients underwent TKA in the Second Affiliated Hospital of Wenzhou Medical University from January 2010 to August 2016 who met inclusion and exclusion criteria were retrospectively collected， and divided into three groups of PCIA， PCEA and CFNB according to the postoperative analgesia methods. Then randomly extracted 80 patients from each group， and postoperative follow-up VAS scores and adverse reactions were recorded and analyzed. Results The demographic information in three groups showed no significant difference （P 0.05）. As for analgesia effects， there were significant differences in VAS scores among the three groups in the state of rest and activity at every points （P 　　[Key words] Total knee arthroplasty； Patient controlled analgesia； Continous femoral nerve block； Visual analgesia scores 　　全膝关节置换术（total knee arthroplasty，TKA）的主要目的是帮助患者缓解疼痛、纠正畸形、改善功能，从而使患者膝关节获得长期稳定[1]。然而，手术创伤本身亦会给患者带来躯