老年股骨粗隆间骨折围手术期镇痛.docVIP

精品论文 参考文献 老年股骨粗隆间骨折围手术期镇痛 伊斯拉木bull;牙森（新疆维吾尔自治区人民医院骨科 新疆乌鲁木齐 830001） 【摘要】目的 本前瞻随机对照研究旨在评估老年股骨粗隆间骨折围手术期镇痛的临床疗效。方法 2010年3月至2012年2月60名股骨粗隆间骨折老年患者纳入研究，随机分为实验组（围手术期镇痛组）和对照组（因需镇痛组）。术后在不同时间点观察患者的疼痛评分以及围手术期吗啡消耗量和并发症发生率。结果 实验组术后6小时、12小时、24小时、2天的静息痛VAS评分均显著低于对照组；术后24小时、2天、3天活动痛VAS评分均显著低于对照组；围手术期实验组吗啡消耗量为8.67plusmn;8.50mg，对照组吗啡消耗量为17.00plusmn;14.18mg；实验组并发症发生率低于对照组。结论 超前镇痛和多模式镇痛在股骨粗隆间骨折围手术期镇痛中发挥重要作用。本方案可有效控制术后疼痛，减少阿片类药物的使用量，且具有操作简单，副作用少的优点。 【关键词】粗隆间骨折 镇痛 【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2012）17-0385-02 【Abstract】Objective: The aim of this prospective, randomized, controlled study was to evaluate the clinical outcome of peri-operative pain management protocol in senile patients with femoral intertrochanteric fracture. Method: A total of 60 senile patients with femoral intertrochanteric fracture were included in this study from March 2010 to February 2012, and they were randomized into study group (under peri-operative pain management protocol) and control group (received analgesics when VAS was above 5). The VAS at different time points as well as morphine consumption and incidence of complications were recorded. Results: The rest VAS of study group was significantly lower than control group at postoperative 6 hours, 12 hours, 24 hours, and 2 days, and activity VAS of study group was significantly lower than control group at postoperative 24 hours, 2 days, and 3 days.; morphine consumption was 8.67plusmn;8.50mg in study group while 17.00plusmn;14.18mg in control group with significant differences. The incidence of complication was lower in study group.Conclusion: Preemptive analgesia and multimodal analgesia played an important role in the pain management of patients with intertrochanteric fracture. This protocol can effectively control postoperative pain and reduce the use of opioids, and it was easy to proform with fewer side effects. 【Key words】 intertrochanteric fracture analgesia 股骨粗隆间骨折是老年人常见的创伤类型，随