摘要
目的 探讨酮咯酸氨丁三醇超前镇痛对膝骨关节炎关节置换患者炎性因子及应激状态的影响.方法 选择因膝骨关节炎接受膝关节置换患者61例,随机分为对照组(30例)及观察组(31例),对照组仅接受静脉麻醉复合硬膜外阻滞,观察组在此基础上接受酮咯酸氨丁三醇超前镇痛,对比分析2组患者术前及术后VAS评分、细胞因子及皮质醇检测水平.结果 观察组患者的术后疼痛VAS评分(24 h、48 h、72 h)均明显低于对照组(P<0.05);观察组术后24 h患者IL-8、TNF-α水平明显低于对照组(P<0.05),观察组术后48 h的IL-6、IL-8、TNF-α水平均明显低于对照组(P<0.05).观察组患者术后24 h Cor明显低于对照组同期水平(P<0.05),观察组术后48 h Cor及ACTH水平均明显低于对照组(P<0.05).结论 酮咯酸氨丁三醇超前镇痛可明显缓解膝骨关节炎关节置换术后疼痛,并且可显著降低炎性因子水平,减轻患者术后应激状态.
Abstract
Objective To study the ketone luo acid tromethamine analgesia in patients with knee osteoarthritis joint replacement in advance of inflammatory factor and the influence of stress state. Methods Choice for knee osteoarthritis knee joint replacement patients 61 cases, were randomly divided into control group (30 caese) and the observation group (31caese), the control group only received intravenous anesthesia compound epidural block, on the basis of the observation group receied ketone luo acid tromethamine analgesia in advance, the contrast analysis of two groups of patients with preoperative and postoperative VAS score, cytokines and cortisol levels. Results The observation group of patients with postoperative pain VAS score (24 h, 48 h, 72 h) were significantly lower than control group (P<0.05);Observation group with 24h after IL - 8, TNF alpha level significantly lower than the control group (P<0.05), the observation group after 48h of IL-6, IL-8, TNF-a levels were significantly lower than control group (P<0.05).0bservation group 24h after surgery in patients with Cor significantly lower than the control level (P<0.05), after 48 h Cor and ACTH level observation group were significantly lower than the control group (P<0.05).Conclusion Ketone luo acid tromethamine analgesia in advance can obviously relieve knee osteoarthritis pain after joint replacement, and can significantly reduce inflammatory factor levels, reduce the postoperative patients with stress state.
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