摘要
【目的】探讨超声引导下神经阻滞对全膝关节置换(TKA)患者手术后视觉模拟疼痛评分(VAS)、血清疼痛介质5-羟色胺(5-HT)、p-内啡肽(p-EP)、白细胞介素-6(IL-6)、血浆P物质(SP)的影响。【方法】本院实施下肢神经阻滞TKA手术的患者90例,随机分为两组,各45例,观察组术后采用超声引导下神经阻滞镇痛,对照组采用关节腔内注射镇痛药物镇痛。比较两组患者术后48h内静息、活动时的VAS评分,对比术前、术后24h两组患者血清5-HT、p-EP、SP、lL-6水平变化。【结果】静息状态及活动状态下,观察组患者在术后6h、12h、24h、48h的VAS评分均低于对应时间点的对照组患者,且两组之间比较差异均有显著性(P<0.05)。术前两组患者的血清5-HT、p-EP、SP、IL-6水平差异无显著性(P>0.05);术后24h,观察组患者的血清SP、IL-6水平低于,5-HT、p-EP水平显著高于对照组(P<0.05)。【结论】超声引导下神经阻滞对TKA患者具有更好的镇痛效果,可调节患者疼痛相关因子的释放。
[Objective]To investigate the effects of ultrasound-guided never block on postoperative visual analogue pain score(VAS),serum serotonin(5-HT),(3-endorphin(p-EP),plasma substance P(SP)and interleukin 6(1L-6)in patients undergoing total knee arthroplasty(TKA).[Methods] Ninety patients with lower extremity nerve block TKA in our hospital were randomly divided into two groups with 45 cases each.The experimental group was treated with ultrasound-guided nerve block analgesia and the control group was treated with intra-injection of analgesic drugs.The VAS scores of the patients at rest and activity within 48 hours after operation were compared between the two groups.The serum 5-HT,p-EP,SP.IL-6 were compared between the preoperative and postoperative 24h.6 levels.[Results]No matter of resting and active states,the VAS scores of patients in the experimental group at 6h.12h.24h,48h after operation were lower than those in the control group at the corresponding time points.The differences were statistically significant(P<0.05).Before operation,the serum of levels of EP;SP and IL-6 ihe two groups were no significant differences(P>0.05).The serum SP and IL-6 levels in the experimental group at 24h after surgery were lower,while the lev-els of 5-HT and p-EP were significantly higher than those in the control group(P<0.05).[Conclusion]UI-trasound-guided nerve block has better analgesic effects on TKA patients through regulating the release of pain-related factors in patients.
作者
刘金龙
吕宝胜
陈欢
王佳路
LIU Jin-long;LV Bao-shetig;CHEN Huan(Hebei Yanda Hospital,Langfang Hebei 065201)
出处
《医学临床研究》
CAS
2020年第10期1465-1467,共3页
Journal of Clinical Research
基金
河北省2016年度医学科学研究重点课题计划(No.20160323)
