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华西医学  2015 

股神经阻滞在前交叉韧带重建术后对疼痛和康复的影响

DOI: 10.7507/1002-0179.20150582, PP. 2050-2053

Keywords: 股神经阻滞,前交叉韧带重建术,镇痛,康复

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Abstract:

目的?探讨股神经阻滞在前膝交叉韧带重建术后对疼痛和康复的影响。方法?将2014年6月-9月收治的62例拟行前膝交叉韧带重建术的患者随机分为股神经阻滞组和空白对照组,每组各31例。股神经阻滞组于术前3d定时给予塞来昔布口服(200mg,2次/d),于手术室行术侧股神经阻滞(0.75%罗哌卡因3mL)。空白对照组只在术前3d给予相同剂量的塞来昔布口服而不行股神经阻滞。术后两组均行24h冰敷治疗。测量两组患者在术后2h、1d、2d、7d、14d、28d活动后疼痛视觉模拟评分(VAS)以及膝关节活动度。评估患者术后2、6、12、24、48h及出院当天的股四头肌肌力等级。并记录患者在住院期间吗啡抢救的次数及用量,恶心呕吐等不良反应的发生次数等。结果?前膝交叉韧带重建术后2h~7d股神经阻滞组活动后VAS评分低于空白对照组,差异有统计学意义(P<0.05),第14、28天差异无统计学意义(P>0.05)。膝关节活动度股神经阻滞组在2h~28d都优于空白对照,差异有统计学意义(P<0.05)。股神经阻滞组术后股四头肌肌力在术后2~12h低于空白对照组,差异有统计学意义(P<0.05),24h至出院差异无统计学意义(P>0.05)。股神经阻滞组吗啡抢救用量均少于空白对照组,差异有统计学意义(P<0.05);两组恶心呕吐等不良反应发生率差异无统计学意义(P>0.05)。结论?股神经阻滞在前交叉韧带重建术后能有效减轻疼痛,并且有助于患者关节功能的康复,值得推广应用。

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