针刺复合局部麻醉与局部麻醉配合镇痛药物应用于经皮椎体成形术中的效果比较
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R274.1;R687.3

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Comparison of Application Effect of Acupuncture Combined with Local Anesthesia with That of Local Anesthesia Combined with Analgesic Medicine on Percutaneous Vertebroplasty
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    摘要:

    目的:观察并比较针刺复合局部麻醉与局部麻醉配合镇痛药物应用于经皮椎体成形术(PVP) 的效果。方法:选取120 例行PVP 术的骨质疏松性脊柱压缩性骨折患者,随机分为观察组及对照组,各60 例。对照组予以镇痛药物配合局部麻醉,观察组予以针刺复合局部麻醉,比较2 组于术前(t1)、穿刺时(t2)、灌注骨水泥时(t3)、手术结束时(t4) 的视觉模拟评分法(VAS) 疼痛评分、Ramsay 镇静评分、血压、心率;比较2 组麻醉药物用量、麻醉时间及手术时间。结果:t1 时刻,2 组VAS评分比较,差异无统计学意义(P>0.05);与对照组t2~t4 时刻比较,观察组同期VAS 评分较低(P<0.05)。t1~t4 时刻,2 组Ramsay 评分、收缩压、舒张压及心率比较,差异均无统计学意义(P>0.05)。与对照组比较,观察组麻醉药物用量减少(P<0.05),麻醉时间延长(P<0.05);2 组手术时间比较,差异无统计学意义(P>0.05)。结论:针刺复合局部麻醉应用于PVP 术相较于镇痛药物配合局部麻醉具有更好的镇痛效果,可减少麻醉药物用量,且在生命体征平稳的维持与镇痛药物具有相似作用,但麻醉时间有所延长。

    Abstract:

    Abstract:Objective:To observe and compare the application effect of acupuncture combined with local anesthesia with that of local anesthesia combined with analgesic medicine on percutaneous vertebroplasty(PVP). Methods : A total of 120 cases of patients with osteoporotic vertebral compression fractures who underwent PVP were selected and randomly divided into the observation group and the control group, 60 cases in each group. The control group was given local anesthesia combined with analgesic medicine, and the observation group was given acupuncture combined with local anesthesia. Before surgery(t1), during puncture(t2), during bone cement perfusion(t3), and at the end of surgery(t4), the score of Visual Analogue Scale(VAS) of pain, Ramsay sedation score, blood pressure, and heart rate were compared between the two groups. The dosage of analgesic medicine,duration of anesthesia,and duration of surgery were compared between the two groups. Results:At t1,there was no significant difference being found in the comparison of the score of VAS between the two groups(P>0.05);from t2 to t4,the score in the observation group was lower than that in the control group(P<0.05). From t1 to t4, when compared Ramsay score, systolic pressure, diastolic pressure, and heart pressure between the two groups,there was no significance in differences(P>0.05). The dosage of analgesic medicine was less than that in the control group(P<0.05),and duration of anesthesia was longer(P<0.05). There was no significant difference being found in the comparison of the duration of surgery between the two groups(P>0.05). Conclusion: The application of acupuncture combined with local anesthesia to PVP has a better analgesic effect than local anesthesia combined with analgesic medicine,with a smaller dosage of analgesic medicine. Acupuncture combined with local anesthesia has a similar effect to analgesic medicine in terms of maintenance of stability of vital signs,but duration of anesthesia is prolonged.

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应礼,张雨书.针刺复合局部麻醉与局部麻醉配合镇痛药物应用于经皮椎体成形术中的效果比较[J].新中医,2021,53(15):128-131

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  • 在线发布日期: 2021-08-10
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