分类号：R684密级：公开
U D C ：610
编号：2019216105109065
2016级攻读临床医学硕士学位研究生毕业论文
TKA 术中不同部位注射罗哌卡因对术后短期
内疼痛缓解的影响
Effects of ropivacaine injection at different sites during TKA on short-term postoperative pain relief
二零一九年三月
指导教师：
张国秋教授学生姓名：
董足男学科专业名称：
外科学（骨外科）研究方向：
临床技能训练与研究学院(系、部)：青海大学研究生院
Master Disrtation of Qinghai University
（Professional Degree）
Effects of ropivacaine injection at different sites during TKA on short-term postoperative pain relief生肖马
Supervisor:Professor Zhang Guoqiu
Candidate:Dong Zunan
Academic Major Applied for:Master’s degree
Specific Major:Clinical skills training and rearch College(Department):Graduate College of Qinghai University
鸿浩之志May,2019
摘要
怎样做书签
目的：探讨TKA术中不同部位局部注射罗哌卡因对患者术后短期内疼痛缓解的疗效及术后短期内膝关节功能恢复情况。
方法：选取2016年10月到2018年12月于我科因单侧膝关节骨性关节炎住院并行全膝人工关节置换术的患者100例，男30例，女70例，年龄55-75岁。将100名患者根据区组随机化的方法随机分为两组，A组50人，B组50人。A组于手术中假体安装前后将1支盐酸罗哌卡因注射液（100mg；10ml）使用生理盐水稀释至100ml局部注射在关节囊全层和皮下组织，B组于术中膝关节假体安放前后将100ml由生理盐水稀释后的1支盐酸罗哌卡因注射液（100mg；10ml）局部注射在后关节囊、半月板残端、内外侧副韧带、股四头肌肌腱、胫骨骨膜周围、关节囊全层以及皮下组织。手术及药物局部注射均由同一位具有丰富经验的医师完成。术后对两组患者进行6h、12h、24h、48h、72h的静息痛VAS（visual analogue scale）评分，24h、48h、72h时的活动痛VAS评分和ROM（range of motion）。将所收集到的临床数据进行整理并使用统计软件进行数据统计分析。
结果：100例患者均术后恢复良好，未出现假体感染、下肢深静脉血栓等手术相关严重并发症。全关节罗哌卡因注射组术后各时间点的RVAS评分、AVAS评分明显低于单纯关节囊及皮下注射组，两组之间的差异有统计学意义（P<0.05）。全关节罗哌卡因注射组术后24h、48h、72h的ROM均优于单纯关节囊及皮下注射组，具有统计学差异（P<0.05）。英雄简笔画
结论：在TKA术中应用罗哌卡因注射液进行全关节结构注射比单纯关节囊皮下注射能够更有效缓解患者术后短期内的疼痛，改善患者术后膝关节活动度，促进患者术后康复，值得临床推广应用。
关键词：TKA罗哌卡因局部注射术后镇痛
范巴斯滕
I
Abstract
山东有什么好玩的Objective:To investigate the effect of local injection of ropivacaine in different parts of TKA on short-term postoperative pain relief and short-term postoperative recovery of knee joint function.
Methods:From October2016to December2018,100patients,including30 males and70females aged55-75years,who were hospitalized in our department for unilateral knee osteoarthritis and underwent total knee artificial joint replacement were lected.100patients were randomly divided into two groups,50in group A and50in group B according to the method of block randomization.In group A,1 ropivacaine hydrochloride injection(100mg;10ml)was diluted with normal saline to 100ml before and after the prosthesis was installed during the operation,and local injection was performed in the whole layer and subcutaneous tissue of the joint capsule,In group B,100ml of ropivacaine hydr
玄秘塔碑ochloride injection(100mg;10ml) diluted with normal saline before and after the intraoperative placement of knee prosthesis was injected locally into the posterior joint capsule,meniscus residual, medial and lateral collateral ligaments,quadriceps femoris tendon,periperiosteal tibia, whole layer of joint capsule and subcutaneous tissue.Surgery and local injection were performed by the same experienced physician.Postoperative obrvation, asssment and recording of the resting VAS(visual analogue scale)score of the patients in the two groups at6h,12h,24h,48h and72h,and the active VAS score and the ROM(range of motion)of the patients in the two groups at24h,48h and72h. Organizing and clinical data were collected by using statistical software for statistical analysis.
Results:All the100patients recovered well after the operation,and there were no vere complications related to prosthesis infection and deep vein thrombosis of lower limbs.RVAS and AVAS scores of the whole joint ropivacaine injection group at each time point after surgery were significantly lower than tho of the simple joint capsule and subcutaneous injection group,and the difference between the two groups was statistically significant(P<0.05).The ROM of the whole joint ropivacaine
安全生产培训总结II
