超声引导下连续隐神经置管阻滞在膝关节置换术后的应用价值.docxVIP

超声引导下连续隐神经置管阻滞在膝关节置换术后的应用价值 　　[摘要]目的探討超声引导下连续隐神经置管阻滞在膝关节置换术后的应用价值。方法选取2017年7月～2019年7月我院收治的80例椎管内麻醉下行膝关节置换术的患者作为研究对象，根据随机数字表法分为对照组与观察组，每组各40例。对照组患者实施静脉持续自控镇痛，观察组患者则应用超声引导下连续隐神经置管阻滞。比较两组患者术后不同时间点的疼痛评分、术后下床时间、术后48h膝关节活动度、术后住院时间以及恶心呕吐、头晕、尿潴留、下肢肌力降低等并发症的发生率。结果观察组患者术后12、24及48h的疼痛评分均低于对照组，差异有统计学意义（p0.05）;观察组患者术后下床时间早于对照组，术后48h膝关节活动度大于对照组，术后住院时间短于对照组，差异均有统计学意义（p0.05）;观察组患者术后48h的并发症总发生率低于对照组，差异有统计学意义（p0.05）。结论膝关节置换术患者实施超声引导下连续隐神经置管阻滞镇痛，能够有效减轻术后疼痛，促进早期下床及关节功能恢复，且并发症少，安全性高。 　　[关键词]隐神经阻滞;连续神经阻滞;超声引导;膝关节置换;术后应用 　　[abstract]objectivetoexploretheapplicationvalueofultrasound-guidedcontinuoussaphenousnervecatheterizationblockafterkneearthroplasty.methodsatotalof80csaeswithkneearthroplastyunderspinalanesthesiafromjuly2017tojuly2019treatedinourhospitalwereselected.accordingtotherandomnumbertablemethod，theyweredividedintocontrolgroupandobservationgroup，with40casesineachgroup.thecontrolgroupreceivedintravenouscontinuouspatient-controlledanalgesia，andtheobservationgroupreceivedultrasound-guidedcontinuoussaphenousnerveblockanalgesia.thepainscoreatdifferenttimepointsafteroperation，thetimeofgettingoutofbedafteroperation，thekneejointactivity48hafteroperation，thehospitalizationtimeafteroperation，andtheincidencerateofnausea，vomiting，dizziness，urinaryretentionandlowerlimbmusclestrengthreductionwerecomparedbetweenthetwogroups.resultsthepainscoresintheobservationgroupat12，24and48hafteroperationwerelowerthanthoseinthecontrolgroup，thedifferenceswerestatisticallysignificant（p0.05）.theambulationtimeintheobservationgroupafteroperationwasearlierthanthatinthecontrolgroup，thekneejointactivityat48hafteroperationwasgreaterthanthatinthecontrolgroup，thehospitalizationtimeafteroperationwasshorterthanthatinthecontrolgroup，thedifferenceswerestatisticallysignificant（p0.05）.thetotalincidenceofcomplicationsintheobservationgroupat48hafteroperationwerelowerthancontrolgroup，thedifferencewasstatisticallysignificant（p0.05）.conclusionforpatientsundergoingkneearthroplasty，ultrasound-guidedcontinuoussaphenousn