摘要
目的分析术后镇痛对粗隆间骨折PFNA术后快速康复的影响。方法选择2019年2月1日—2020年2月1日台山中医院收治的80例行PFNA术治疗的粗隆间骨折患者为研究对象,按数字随机法分为治疗组和对照组,各40例。对照组以塞来昔布进行辅助镇痛,治疗组在术后以镇痛泵维持0.3%罗哌卡因持续硬膜给药辅助镇痛,对比两组术后康复情况以及VAS评分和髋关节Harris评分变化。结果观察组术后下床时间和术后恢复功能锻炼时间短于对照组,差异有统计学意义(P<0.05);术后1周、4周和3月Harris髋关节功能评分显著高于术后24 h和48 h,且观察组评分较对照组更高,两组对比差异显著(P<0.05);术后4周和术后3月VAS评分明显低于术后24 h、48 h和1周VAS评分且观察组评分低于对照组,两组对比差异显著(P<0.05);观察组手术治疗总有效率和对照组对比差异无统计学意义(P>0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论在股骨粗粗隆间骨折PENA术后加强镇痛可以改善患者疼痛症状,促进髋关节功能恢复,降低不良反应发生,缩短术后康复时间,值得应用。
Objective To analyze the effect of postoperative analgesia on the rapid rehabilitation of PFNA in intertrochanteric fracture. Methods 80 patients with intertrochanteric fracture who were admitted to the hospital from February 1, 2019 to February1, 2020 received PFNA treatment were selected as the subjects. They were randomly divided into treatment group and control group, with 40 cases in each group. The control group was treated with crecoxib for auxiliary analgesia, while the treatment group was treated with an analgesic pump to maintain 0.3% of ropivacaine for continuous epidural analgesia. Postoperative recovery, VAS score and hip Harris score of the two groups were compared. Results The postoperative out-of-bed time and postoperative functional recovery exercise time of the observation group were shorter than that of the control group, and the difference was statistically significant(P<0.05). Harris hip function score 1 week, 4 weeks and 3 months after surgery was significantly higher than that 24 h and 48 h after surgery, and the score in the observation group was higher than that in the control group(P<0.05). VAS scores 4 weeks and 3 months after surgery were significantly lower than those 24 h, 48 h and 1 week after surgery, and the scores in the observation group were lower than those in the control group(P<0.05). There was no significant difference in the total effective rate between the observation group and the control group(P>0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Strengthening analgesia after PENA for intertrochanteric fracture of femur can improve the patient’s pain symptoms, promote the recovery of hip joint function, reduce the occurrence of adverse reactions, and shorten the postoperative recovery time, which is worthy of application.
作者
黄罩龙
周秀萍
赵翠苗
HUANG Zhao-long;ZHOU Xiu-ping;ZHAO Cui-miao(Taishan Hospital of Traditional Chinese Medicine,Taishan,Guangdong,529200,China)
出处
《黑龙江医学》
2020年第8期1033-1036,共4页
Heilongjiang Medical Journal
基金
江门市卫生计生局科学技术研究项目(19A086)。
关键词
镇痛
粗隆间骨折
股骨近端髓内钉内固定术
快速康复
Analgesia
Intertrochanteric fracture
Internal fixation of proximal femoral intramedullary nail
Rapid recovery
