摘要
目的观察多模式镇痛用于全髋关节置换术高龄患者的临床效果,以及对其血清炎性因子、胰岛素样生长因子1(IGF-1)水平的影响。方法选取医院骨科2018年2月至2020年2月收治的全髋关节置换术高龄患者160例,按随机数字表法分为对照组(常规镇痛管理)和观察组(多模式镇痛管理),各80例。结果两组患者术后12 h、术后24 h视觉模拟评分(VAS)量表评分均显著高于术前(P<0.05),术后36 h VAS评分显著低于术后12 h和术后24 h(P<0.05),且观察组术后12 h、术后24 h、术后36 h的VAS评分均显著低于对照组(t=4.156,4.390,8.610,P<0.05);观察组并发症发生率为7.50%,显著低于对照组的18.75%(χ^(2)=4.440,P<0.05);两组患者术后7 d的血清白细胞介素6、白细胞介素1β、肿瘤坏死因子-α和IGF-1的水平均显著高于术前(P<0.05),且观察组术后7 d上述指标水平均显著低于对照组(P<0.05);观察组和对照组术后6个月的Harris评分均显著高于术前(t=26.819,20.301,P<0.005),且观察组术后6个月Harris评分显著高于对照组(t=7.707,P<0.005)。结论多模式镇痛用于全髋关节置换术高龄患者,可降低疼痛程度,减少术后并发症,缓解炎性反应,提高术后功能康复效果。
Objective To observe the clinical efficacy of multimodal analgesia in elderly patients undergoing total hip arthroplasty and its effects on the levels of serum inflammatory factor and insulin-like growth factor-1(IGF-1).Methods A total of 160 elderly patients underwent total hip arthroplasty admitted to the Department of Orthopedics of the hospital from February 2018 to February 2020 were selected and divided into the control group(routine analgesia management)and the observation group(multimodal analgesia management)according to the random number table method,with 80 cases in each group.Results The visual analogue scale(VAS)scores at 12 h and 24 h after the operation in the two groups were significantly higher than those before the operation(P<0.05),the VAS scores at 36 h after the operation in the two groups were significantly lower than those at 12 h and 24 h after the operation(P<0.05),and the VAS scores at 12 h,24 h and 36 h after the operation in the observation group were significantly lower than those in the control group(t=4.156,4.390,8.610,P<0.05).The total incidence of complications in the observation group was 7.50%,which was significantly lower than 18.75%in the control group(χ^(2)=4.440,P<0.05).The levels of serum interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and IGF-1 on the seventh day after the operation in the two groups were significantly higher than those before the operation(P<0.05),and the above index levels on the seventh day after the operation in the observation group were significantly lower than those in the control group(P<0.05).The Harris scores on the sixth month after the operation in the observation group and the control group were significantly higher than those before the operation(t=26.819,20.301,P<0.005),and the Harris score on the sixth month after the operation in the observation group was significantly higher than that in the control group(t=7.707,P<0.005).Conclusion Multimodal analgesia in elderly patients undergoing total hip arthroplasty can reduce the degree of pain and postoperative complications,alleviate inflammatory reactions and improve the effects of postoperative functional rehabilitation.
作者
迟晓慧
侯俊德
王瑞
陈永学
程晶晶
CHI Xiaohui;HOU Junde;WANG Rui;CHEN Yongxue;CHENG Jingjing(Department of Anesthesiology,Handan Central Hospital,Handan,Hebei,China 056000)
出处
《中国药业》
CAS
2022年第9期114-117,共4页
China Pharmaceuticals
关键词
多模式镇痛
全髋关节置换术
高龄
炎性因子
胰岛素样生长因子1
multimodal analgesia
total hip arthroplasty
elderly
inflammatory factor
insulin-like growth factor-1
