股神经阻滞与股收肌管阻滞在TKA术后 患者跌倒的临床观察

目的 探究连续股神经阻滞与连续股收肌管阻滞在TKA术后患者跌倒中的应用价值。方法 选取我院2015年7月~2018年6月收治的84例行TKA术治疗的患者作为研究对象，随机分为参照组和研究组，每组42例。参照组实施连续股神经阻滞，研究组实施连续股收肌管阻滞，比较两组治疗前后静息痛和活动痛VAS评分、各时间点股四头肌肌力和关节活动度情况。结果治疗前，参照组和研究组的静息痛VAS评分、活动痛VAS评分比较，差异无统计学意义（P＞0.05）；治疗后，研究组的静息痛VAS评分、活动痛VAS评分低于参照组，但差异无统计学意义（P＞0.05）；治疗24 h和48 h后，研究组的股四头肌肌力和关节活动度均优于参照组，差异有统计学意义（P＜0.05）；治疗72 h后，两组的股四头肌肌力比较，差异无统计学意义（P＞0.05），关节活动度比较，差异有统计学意义（P＜0.05）。结论 针对TKA术后患者跌倒现象，实施连续骨神经组织和连续股收肌管组织的效果均比较理想，但连续股收肌管阻滞在股四头肌肌力和膝关节活动度的改善方面作用更大，更加适合应用在治疗中。

Clinical Observation of Femoral Nerve Block and Femoral Muscle Block in Patients with Fall after TKA

Abstract:Objective To investigate the value of continuous femoral nerve block and continuous femoral muscle block in the fall of patients after TKA. Methods Selected 84 patients who underwent TKA in our hospital from July 2015 to June 2018 were enrolled in the study. They were randomly divided into a reference group and a study group, with 42 cases in each group. The study group underwent continuous femoral nerve block. The study group performed continuous femoral muscle block, and compared the VAS scores of resting pain and active pain before and after treatment, and the muscle strength and joint mobility of the quadriceps at each time point. Results Before treatment, the VAS scores of the resting group and the VAS scores of the active pain in the reference group and the study group were not significantly different (P>0.05). After treatment, the VAS score and VAS score of resting pain in the study group were lower than the reference group, but the difference was not statistically significant (P>0.05). After 24 h and 48 h of treatment, the quadriceps muscle strength of the study group The joint mobility was better than that of the reference group,the difference was statistically significant (P<0.05). After 72 h of treatment, there was no significant difference in the quadriceps muscle strength between the two groups (P>0.05); the difference in joint mobility was statistically significant (P<0.05).Conclusion The effect of continuous skeletal nerve tissue and continuous femoral duct tissue is satisfactory for patients with TKA after fall, but continuous femoral muscle block is in the improvement of quadriceps muscle strength and knee joint mobility. It has a greater effect and is more suitable for use in therapy.