帕瑞昔布联合股神经阻滞用于膝关节置换术后镇痛的效果评价及其对患者免疫功能的影响

目的:探讨帕瑞昔布联合股神经阻滞用于膝关节置换术后镇痛的效果及对患者免疫功能的影响。方法:选择2016年10月-2017年10月我院骨科住院部收治并行单侧膝关节置换的患者108例,按镇痛方式分为对照组和观察组各54例。对照组患者采用单纯股神经阻滞,观察组采用股神经阻滞联合帕瑞昔布。比较两组静息及活动状态下术后VAS评分、术后膝关节HSS评分、不良反应的发生情况及免疫指标的变化情况。结果:静息及活动状态下,观察组术后VAS评分均明显低于对照组(P均0.05),膝关节HSS评分显著高于对照组(P0.05)。两组术后不良反应的发生情况比较差异无统计学意义(P0.05)。手术结束时,两组CD4~+较麻醉前均显著下降(P均0.05);术后72 h,两组CD4~+、CD8~+及CD4~+/CD8~+较麻醉前均无显著差异(P均0.05)。观察组术后72 h CD4~+比对照组高(P0.05),而CD4~+/CD8~+显著低于对照组(P0.05)。结论:帕瑞昔布联合股神经阻滞对膝关节置换术后镇痛临床效果好,利于保护和改善患者免疫功能,促进膝关节功能的康复。

Evaluation of the Analgesia Effect of Parecoxib Combined with Femoral Nerve Block after Knee Replacement Operation and Its Effect on the Immune Function

ABSTRACT Objective: To explore the analgesia effect of parecoxib combined with femoral nerve block after the knee replacement operation and its effect on the immune function. Methods: 108 cases of patients who underwent unilateral knee replacement in our hospital from October 2016 to October 2017 were selected and divided into the control group and the observation group by analgesic method, with 54 cases in each group. Patients in the control group were treated with femoral nerve block, while patients in the observation group were treated with femoral nerve block combined with parecoxib. The VAS score, HSS score, the occurrence of adverse reactions and the changes of immune indexes were compared between the two groups. Results: The VAS score of resting and activity of observation group were lower than those of the control group (P<0.05). The HSS score of observation group was significantly higher than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). At the end of the operation, the CD4⁺ of both groups were significantly lower than those before anesthesia(P<0.05). There was no significant differ- ence in the CD4⁺, CD8⁺ and CD4⁺/CD8⁺ between the two groups(P>0.05). CD4⁺/CD8⁺was significantly lower in the observation group than that in the control group(P<0.05). Conclusion: Parecoxib combined with femoral nerve block for postoperative analgesia after knee replacement is good, it can improve the immune function of patients and promote the rehabilitation of knee function.