河北医学2024,Vol.30Issue(7) :1120-1125.DOI:10.3969/j.issn.1006-6233.2024.07.011

复方倍他米松联合髂筋膜阻滞通过调控TLR4/NF-κB信号通路相关因子在髋关节置换患者术后镇痛中的作用

Clinical Efficacy of Compound Betamethasone Combined with Iliac Fascia Block in Postoperative Analgesia for Patients Undergoing Total Hip Arthroplasty:Effects on TLR4/NF-κB Signaling Pathway

王可心 刘忠 王梦楠 张亚楠 张晨佳 缪凡
河北医学2024,Vol.30Issue(7) :1120-1125.DOI:10.3969/j.issn.1006-6233.2024.07.011

复方倍他米松联合髂筋膜阻滞通过调控TLR4/NF-κB信号通路相关因子在髋关节置换患者术后镇痛中的作用

Clinical Efficacy of Compound Betamethasone Combined with Iliac Fascia Block in Postoperative Analgesia for Patients Undergoing Total Hip Arthroplasty:Effects on TLR4/NF-κB Signaling Pathway

王可心 1刘忠 1王梦楠 1张亚楠 1张晨佳 1缪凡1
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作者信息

  • 1. 河北省承德市中心医院麻醉科,河北 承德 067000
  • 折叠

摘要

目的:探讨复方倍他米松联合髂筋膜阻滞通过调控TLR4/NF-κB信号通路相关因子在髋关节置换患者术后镇痛中的作用.方法:选择了 2022年11月至2023年12月在本院接受治疗的152例髋关节置换患者,患者被随机分成两组:对照组接受髂筋 膜阻滞,试验组接受复方倍他米松和髂筋膜阻滞.比较了两组患者在围术期指标、疼痛评分、髋关节活动度、TLR4/NF-KB信号通路以及不良反应的发生率等参数.结果:观察组和对照组在手术时间、出血量、麻醉时间、首次下床时间及术中输液量等参数上没有显著差异(P>0.05).观察组患者术后24h和术后48h的疼痛评分明显低于对照组(P<0.05),而两组患者术后2h的疼痛评分没有显著差异(P>0.05).术后7d和14d,观察组的髋关节活动度明显高于对照组,术后14d,两组患者的髋关节活动度明显提高(P<0.05).观察组患者术后24h和术后48h的血清TLR4和NF-κB明显低于对照组(P<0.05),而两组患者术前的血清TLR4和NF-κB没有显著差异(P>0.05).治疗期间,观察组和对照组患者均未出现恶心呕吐、皮肤瘙痒等不良反应.结论:复方倍他米松联合髂筋膜阻滞可有效降低患者疼痛程度,恢复髋关节活动度,并与TLR4/NF-κB信号通路表达相关,且安全有效.

Abstract

Objective:To explore the clinical value of compound betamethasone combined with iliac fas-cia block in postoperative analgesia for patients undergoing total hip arthroplasty(THA),and its influence on the TLR4/NF-κB signaling pathway.Methods:A total of 152 patients undergoing THA from November 2022 to December 2023 were included in this study.Patients were randomly divided into two groups:the control group received iliac fascia block,and the experimental group received compound betamethasone and iliac fas-cia block.Parameters compared between the two groups included perioperative indicators,pain scores,hip joint mobility,TLR4/NF-κB signaling pathway factors,and incidence of adverse reactions.Results:Meth-ods:There were no significant differences between two groups in terms of operation time,blood loss,anesthe-sia time,time to first ambulation,and intraoperative fluid infusion(P>0.05).Pain scores at 24 hours and 48 hours postoperatively were significantly lower in the experimental group than in the control group(P<0.05),while there was no significant difference in pain scores at 2 hours postoperatively between the two groups(P>0.05).At 7 days and 14 days postoperatively,hip joint mobility was significantly higher in the experimental group compared to the control group,and at 14 days postoperatively,hip joint mobility improved significantly in both groups(P<0.05).Serum levels of TLR4 and NF-κB at 24 hours and 48 hours postoperatively were significantly lower in the experimental group than in the control group(P<0.05),while there was no signifi-cant difference in serum levels of TLR4 and NF-κB before surgery between the two groups(P>0.05).During treatment,neither group experienced adverse reactions such as nausea,vomiting,or itching.Conclusion:Compound betamethasone combined with iliac fascia block effectively reduces pain intensity,improves hip joint mobility,and is associated with the expression of TLR4/NF-κB signaling pathway in patients undergoing THA,demonstrating safety and efficacy.

关键词

髋关节置换术/复方倍他米松/髂筋膜阻滞/镇痛/Toll样受体4/核因子-κB

Key words

Total hip arthroplasty/Compound betamethasone/Iliac fascia block/Analgesia/Toll-like receptor 4/NF-κB

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基金项目

河北省承德市科技计划项目(202204A011)

出版年

2024
河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
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