摘要
目的 分析神经阻滞与全麻对于桡骨远端骨折患儿早期预后的影响。方法 回顾性分析2019年3月至2022年3月河南省滑县骨科医院收治的桡骨远端骨折患儿共68例的临床资料,均通过闭合复位内固定手术进行治疗,依据术中不同麻醉方式分成对照组(全身麻醉)、观察组(神经阻滞)各34例,比较两组术前及术后不同时间的疼痛视觉模拟量表评分(VAS);术后1个月的腕关节功能、40项恢复质量评分(QoR-40)、腕关节患儿自我评分(PRWE);术后第1 d、术后第2 d及术后第3 d的布洛芬颗粒使用剂量及累计使用剂量;并统计两组术后24 h的恶心呕吐比例。结果 两组术前VAS评分相比,差异无统计学意义(P>0.05);观察组术后即刻、术后12 h、术后24 h、术后48 h、术后72 h、术后2周、术后2个月的VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组的腕关节功能优良率相比,差异无统计学意义(P>0.05)。观察组生理独立、生理舒适、心理支持、情感状态及疼痛方面的QoR-40评分及总分高于对照组,差异有统计学意义(P<0.05)。观察组疼痛、一般活动功能与特殊活动功能方面的PRWE评分及总分低于对照组,差异有统计学意义(P<0.05)。观察组术后第1 d、术后第2 d及术后第3 d的布洛芬颗粒使用剂量及累计使用剂量低于对照组,差异有统计学意义(P<0.05)。观察组的恶心呕吐比例低于对照组,差异有统计学意义(P<0.05)。结论 与全麻相比,神经阻滞用于桡骨远端骨折患儿能更有效减轻其术后早期疼痛感,减少其对于镇痛药的依赖和恶心呕吐发生,改善其早期预后,提升其恢复质量。
Objective To analyze the effect of nerve block and general anesthesia on the early prognosis of children with distal radius fracture. Methods The clinical data of 68 children with distal radius fractures admitted to the Huaxian Orthopedic Hospital of Henan Province from March 2019 to March 2022 were retrospectively analyzed. They were treated by closed reduction and internal fixation. According to different anesthesia methods during the operation, they were divided into control group(general anesthesia) and observation group(nerve block), 34 cases each. The pain visual analogue scale(VAS) scores of the two groups at different times before and after the operation were compared;Wrist joint function, quality of recovery-40questionnaire(QoR-40) and patient rated wrest evaluation(PRWE) were measured 1 month after operation;The doses of ibuprofen granules and the cumulative doses of ibuprofen granules were compared on the 1st day, 2nd day and 3rd day after operation;The proportion of nausea and vomiting in the two groups at 24 hours after operation was also counted. Results There was no significant difference in VAS score between the two groups before operation(P>0.05);The VAS scores of the observation group were significantly lower than those of the control group immediately, 12 hours, 24 hours, 48 hours, 72 hours,2 weeks and 2 months after operation(P<0.05). There was no significant difference in the excellent and good rate of wrist joint function between the two groups(P>0.05). The QoR-40 score and total score of physiological independence, physical comfort, psychological support, emotional state and pain in the observation group were higher than those in the control group,with statistically significant difference(P<0.05). The PRWE score and total score of pain, general activity function and special activity function in the observation group were significantly lower than those in the control group(P<0.05). The dosage and cumulative dosage of ibuprofen granules in the observation group on the 1st, 2nd and 3rd day after operation were lower than those in the control group(P<0.05). The proportion of nausea and vomiting in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with general anesthesia, nerve block for children with distal radius fracture can more effectively reduce their early postoperative pain, reduce their dependence on analgesics and nausea and vomiting, improve their early prognosis and improve their quality of recovery.
作者
武太全
WU Taiquan(Department of Anesthesia,Huaxian Orthopedic Hospital,Henan Province,Anyang Henan 455000,China)
出处
《临床研究》
2023年第2期115-118,共4页
Clinical Research
关键词
神经阻滞
全麻
桡骨远端骨折
早期预后
疼痛
腕关节功能
nerve block
general anesthesia
fracture of distal radius
early prognosis
pain
wrist joint function
