多模式镇痛应用于腰椎管狭窄症患者术后的疗效观察

目的:观察多模式镇痛应用于腰椎管狭窄症患者的临床疗效。方法:选取2019年1-7月于湖南中医药大学第二附属医院行腰椎后路减压椎间植骨融合内固定术的腰椎管狭窄症患者29例,按随机数字表法将患者分为两组:多模式镇痛组15例和常规镇痛组14例。常规镇痛组采用塞来昔布治疗,多模式镇痛组在常规镇痛组治疗的基础上给予针灸和黄芪桂枝五物汤治疗。观察两组患者术后不同时间点视觉模拟评分(visual analog scale,VAS)、C反应蛋白(c-reactive protein,CRP)水平变化。结果:两组患者术后1周、术后10 d、术后2周VAS评分与术后12 h比较,差异有统计学意义(P<0.05)。两组术后12 h、术后1 d、术后3 d、术后1周、术后10 d、术后2周VAS评分组间比较,差异有统计学意义(P<0.05)。两组患者术后12 h、术后1 d、术后3 d、术后1周、术后10 d、术后2周CRP水平与术后12 h比较,差异有统计学意义(P<0.05)。两组术后12 h、术后1 d、术后3 d、术后1周、术后10 d、术后2周CRP水平组间比较,差异有统计学意义(P<0.05)。两组腰椎管狭窄症患者住院总时间、术后下床时间、住院总费用比较,差异具有统计学意义(P<0.05)。两组患者均出现了头晕、呕吐、恶心、尿潴留、失眠等不良反应,两组术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论:多模式镇痛能够有效减轻患者术后疼痛,有效缩短住院时间,减少住院费用。

Observation of the Effect of Multimodal Analgesia on Postoperative Patients with Lumbar Spinal Stenosis

Objective:To observe the clinical curative effect of multimodal analgesia on patients with lumbar spinal stenosis.Methods:A total of 29 patients with lumbar spinal stenosis who underwent posterior decompression and interbody fusion and internal fixation in the Second Affiliated Hospital of Hunan University of CM from January to July 2019 were randomly divided into two groups according to the random number table:the multimodal analgesia group and the conventional analgesia group,with 15 and 14 cases respectively.The conventional analgesia group was treated with celecoxib,while acupuncture and Astragalus and Cinnamon Twig Five Substances Decoction were additionally given to the multimodal analgesia group on the basis of the conventional analgesia group.Then the changes of visual analog scale(VAS)score and C-reactive protein(CRP)were observed at different time points after operation.Results:Comparing the VAS scores of each group at 1 week,10 days and 2 weeks with 12 hours after operation,all the differences were statistically significant(P<0.05).Comparing the VAS scores of two groups at 12 hours,1 day,3 days,1 week,10 days and 2 weeks after operation,all the differences were statistically significant(P<0.05).Comparing the CRP levels of each group at 1 day,3 days,1 week,10 days and 2 weeks with 12 hours after operation,all the differences were statistically significant(P<0.05).Comparing the CRP levels of two groups at 12 hours,1 day,3 days,1 week,10 days and 2 weeks after operation,all the differences were statistically significant(P<0.05).The differences in the total time of hospitalization,the time of leaving bed after operation and the total cost of hospitalization between the two groups were statistically significant(P<0.05).All the patients in the two groups of had dizziness,vomiting,nausea,urinary retention,insomnia and other adverse reactions,and there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:Multimodal analgesia can effectively reduce postoperative pain,shorten the length of stay and reduce the cost of hospitalization.