超声引导收肌管阻滞联合敏感穴位电针对全膝置换术患者康复训练的镇痛效果OA
The analgesic effect of ultrasound-guided adductor canal block combined with sensitive acupoint electroacupuncture in postoperative rehabilitation training of total knee arthroplasty patients
目的 探讨超声引导收肌管阻滞(adductor canal block,ACB)联合敏感穴位电针(sensitive acupoint electroacupuncture,SA-EA)在全膝置换术(total knee arthroplasty,TKA)术后康复训练中的镇痛效果.方法 选取2023年6月至2025年6月于浙江大学医学院附属金华医院行TKA治疗的患者200例,根据随机数字表法分为对照组、传统穴位电针(traditional acupoint electroacupuncture,TA-EA)组、SA-EA组、ACB+TA-EA组和ACB+SA-EA组,每组40例.比较五组患者术后疼痛视觉模拟评分法(visual analogue scale,VAS)评分、膝关节主动活动度(range of motion,ROM)、股四头肌峰力矩、镇痛药物使用情况、康复训练用时及不良反应.结果 ACB+SA-EA组患者术后24h、48h、72h和7d康复训练时的VAS评分均显著低于其余四组(P<0.05);ACB+SA-EA组患者术后48h、72h的膝关节主动ROM均显著优于其余四组(P<0.05);ACB+SA-EA组患者术后48h、72h、7d的股四头肌峰力矩均显著高于其余四组(P<0.05);ACB+SA-EA组患者术后48h舒芬太尼用量、患者静脉自控镇痛按压次数均显著少于其余四组,计时起立行走测试、10m步行试验和总训练用时均显著短于其余四组(P<0.05);ACB+SA-EA组患者的术后恶心、呕吐和总不良反应发生率均显著低于对照组和TA-EA组(P<0.05).结论 超声引导ACB联合SA-EA对TKA术后康复患者镇痛更有效,可提高术后康复效果,减少阿片药物用量和并发症.
Objective To investigate the analgesic effects of ultrasound-guided adductor canal block(ACB)combined with sensitive acupoint electroacupuncture(SA-EA)in postoperative rehabilitation training after total knee arthroplasty(TKA).Methods A total of 200 patients who underwent TKA treatment at Affiliated Jinhua Hospital,Zhejiang University School of Medicine from June 2023 to June 2025 were selected.According to the random number table method,they were divided into control group,traditional acupoint electroacupuncture(TA-EA)group,SA-EA group,ACB+TA-EA group and ACB+SA-EA group,with 40 cases in each group.The visual analogue scale(VAS)score for postoperative pain,range of motion(ROM)of knee joint,the peak torque of quadriceps femoris,the use of analgesic drugs,the duration of rehabilitation training and adverse reactions were compared among five groups of patients.Results The VAS scores of patients in ACB+SA-EA group at 24 hours,48 hours,72 hours and 7 days of rehabilitation treating after surgery were significantly lower than those of other four groups(P<0.05).The active ROM of knee joint in ACB+SA-EA group at 48 hours and 72 hours after surgery were significantly better than those in other four groups(P<0.05).The peak torque of quadriceps femoris in ACB+SA-EA group at 48 hours,72 hours and 7 days after surgery were significantly higher than those in other four groups(P<0.05).The dosage of sufentanil 48 hours after surgery and the number of patient controlled intravenous analgesia compressions in ACB+SA-EA group were significantly less than those in other four groups,the timed up and go test,10-meter walking test and total training time were significantly shorter than those in other four groups(P<0.05).The incidences of postoperative nausea,vomiting and total adverse reactions in ACB+SA-EA group were significantly lower than those in control group and TA-EA group(P<0.05).Conclusion Ultrasound-guided ACB combined with SA-EA is more effective for analgesia in patients recovering after TKA,which can improve the postoperative rehabilitation effect,reduce the dosage of opioid drugs and complications.
朱丹艳;麻国仙;柴华;周勇伟;彭文勇
浙江大学医学院附属金华医院麻醉科,浙江 金华 321000浙江大学医学院附属金华医院麻醉科,浙江 金华 321000浙江大学医学院附属金华医院麻醉科,浙江 金华 321000浙江大学医学院附属金华医院骨一科,浙江 金华 321000浙江大学医学院附属金华医院麻醉科,浙江 金华 321000
医药卫生
收肌管阻滞敏感穴位电针全膝置换术康复训练镇痛
Adductor canal blockSensitive acupoint electroacupunctureTotal knee arthroplastyRehabilitation trainingAnalgesia
《中国现代医生》 2026 (19)
13-17,5
浙江省金华市科技计划重点项目(2022-3-112)
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