肘关节松解术后康复患者应用多模式镇痛方案的生存质量观察
Observation on the quality of life of rehabilitation patients with multi mode analgesia after elbow arthrolysis
投稿时间:2018-11-18  
DOI:10.11724/jdmu.2019.04.06
中文关键词:  肘关节松解术  康复  术后镇痛  生存质量
英文关键词:elbow arthrolysis  rehabilitation  postoperative analgesia  quality of life
基金项目:基金项目:广东省医学科学技术研究基金项目(B2016008)
作者单位
伍翰笙 广东省工伤康复医院 手外伤康复科广东 广州 510440 
邓建林 广东省工伤康复医院 手外伤康复科广东 广州 510440 
张意辉 广东省工伤康复医院 手外伤康复科广东 广州 510440 
罗 燕 广东省工伤康复医院 手外伤康复科广东 广州 510440 
吴 霄 广东省工伤康复医院 手外伤康复科广东 广州 510440 
王海文 广东省工伤康复医院 手外伤康复科广东 广州 510440 
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中文摘要:
      目的 比较创伤性肘关节僵硬松解术后康复患者应用多模式术后镇痛与常规口服药物镇痛的生存质量。方法 分析2015年1月至2018年8月因肘关节僵硬行手术松解并行术后康复的39例患者的临床资料,20例术后早期康复采用常规镇痛方案(对照组,口服塞来昔布),19例术后康复采用多模式镇痛方案(治疗组,连续臂丛神经阻滞+PCA镇痛+口服塞来昔布),对两组患者术后2周和4周的VAS评分(visual analogue score, VAS)、术后肘关节活动度(range of motion, ROM)及术后4周90项症状清单(symptom checklist 90,SCL-90)评分进行对比分析。结果 治疗组患者术后肘关节活动度与对照组患者对比,差异无统计学意义(P>0.05);术后2周和4周的VAS评分,对照组为(5.65±0.40)分和(4.56±0.44)分,治疗组为(2.55±0.52)分和(1.82±0.59)分,治疗组均较对照组低,差异有统计学意义(P<0.05);术后4周SCL-90量表的总分、躯体化、人际关系敏感及焦虑项目评分治疗组较对照组低,差异有统计学意义(P<0.05)。结论 创伤性肘关节僵硬松解术后康复配合多模式镇痛能明显降低患者术后疼痛程度,减少疼痛对患者心理的负面作用,提高患者治疗舒适度。
英文摘要:
      Objective To compare the quality of life of patients with multi mode analgesia and oral drug analgesia in postoperative rehabilitation of elbow joint arthrolysis by prospective randomized controlled trial.  Methods A retrospective analysis was performed on 39 patients with elbow ankylosis who was treated by elbow joint arthrolysis and postoperative rehabilitation from January 2015 to August 2018 in Department of Hand Injury Rehabilitation, Guangdong Provincial Work Injury Rehabilitation Hospital. Among them, 20 patients underwent routine analgesia in postoperative rehabilitation (control group, oral Celecoxib) and 19 patients received multi mode analgesia in postoperative rehabilitation (treatment group, continuous brachial plexus block, patient controlled analgesia and oral Celecoxib). The postoperative VAS score, the elbow ROM at 2 weeks and 4 weeks and SCL-90 score 4 weeks after operation were compared between two groups.  Results There was no statistic difference in the mean of postoperative elbow ROM between two groups(P>0.05). The control group’s postoperative mean of VAS score at 2 weeks and 4 weeks were (5.65±0.40)and(4.56±0.44), the treatment group’s postoperative mean of VAS score at 2 weeks and 4 weeks were (2.55±0.52)and (1.82±0.59), the differences were statistically significant(P<0.05). Comparing to control group, the treatment group’s postoperative mean of SCL-90 score, Summarization, Interpersonal sensitivity and Anxiety factors at 2 weeks were lower, the differences were statistically significant(P<0.05).  Conclusion Rehabilitation combined with multi mode analgesia after traumatic elbow stiffness arthrolysis can significantly reduce postoperative pain, reduce the negative effects of pain on patients' psychology, and improve patients' treatment comfort.
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