血府逐瘀丸联合收肌管阻滞对全膝关节置换术患者术后炎症因子的影响及在心肌保护中的应用效果OA
The Effect of Xuefu Zhuyu Pills Combined with Adductor Canal Block on Postoperative Inflammatory Factors in Patients Undergoing Total Knee Arthroplasty and Its Application in Myocardial Protection
目的:探讨血府逐瘀丸联合收肌管阻滞对全膝关节置换术患者术后炎症因子的影响及其在心肌保护中的应用效果.方法:选取 2021 年 12 月—2023 年 6 月在赣州市人民医院择期行全膝关节置换术的患者 88 例,随机将患者分为试验组(n=46)和对照组(n=42),两组均行气管插管全身麻醉,在此基础上试验组采用收肌管阻滞联合血府逐瘀丸治疗,对照组仅采用常规静脉镇痛泵.比较两组镇痛效果,手术前后炎症因子、心肌损伤标志物及心功能指标水平.结果:试验组镇痛满意率为 78.26%,高于对照组的 57.14%,差异有统计学意义(P<0.05).麻醉诱导前(T0)、术后 14 d(T4),两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及超敏肌钙蛋白(hs-cTn)、肌酸激酶同工酶(CK-MB)水平比较,差异均无统计学意义(P>0.05);而术后 1 d(T1)、术后 4 d(T2)、术后 7 d(T3),试验组hs-CRP、TNF-α、IL-6 及hs-cTn、CK-MB水平均低于对照组,差异均有统计学意义(P<0.05).T0、T4 时间点,两组左室舒张期容积(EDV)、每搏输出量(SV)水平比较,差异均无统计学意义(P>0.05);而T1、T3 时间点,试验组EDV、SV、射血分数(EF)水平均高于对照组,试验组T4 EF高于对照组,差异均有统计学意义(P<0.05).结论:血府逐瘀丸联合收肌管阻滞可提高全膝关节置换术患者的镇痛效果,有效抑制炎症因子水平及减轻心肌细胞损伤,改善心功能.
Objective:To investigate the effect of Xuefu Zhuyu Pills combined with adductor canal block on postoperative inflammatory factors in patients with total knee arthroplasty and its application effect in myocardial protection.Method:A total of 88 patients who underwent elective total knee arthroplasty in Ganzhou People's Hospital from December 2021 to June 2023 were selected,the patients were randomly divided into experimental group(n=46)and control group(n=42),and both groups underwent general anaesthesia by tracheal intubation,on which the experimental group was treated with adductor canal block combined with Xuefu Zhuyu Pills,while the control group only used conventional intravenous analgesic pumps.The control group only used conventional intravenous analgesic pump.The analgesic effect,inflammatory factor,myocardial injury markers and cardiac function indexes before and after surgery were compared between the two groups.Result:The satisfaction rate of analgesia in the experimental group was 78.26%,which was higher than 57.14% in the control group,the difference was statistically significant(P<0.05).Before anesthesia induction(T0),14 d after surgery(T4),there were no significant differences in the levels of hypersensitive C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive troponin(hs-cTn)and creatine kinase isoenzyme(CK-MB)between the two groups(P>0.05);1 d after surgery(T1),4 d after surgery(T2),7 d after surgery(T3),the levels of hs-CRP,TNF-α,IL-6,hs-cTn and CK-MB in experimental groups were lower than those in control group,the differences were statistically significant(P<0.05).at T0 and T4 time points,the two groups had lower left ventricular diastolic volume(EDV),per beat output(SV)levels were compared,the differences were not statistically significant(P>0.05);while at T1 and T3 time points,the levels of EDV,SV and and ejection fraction(EF)of the experimental group were higher than those of the control group,the EF of T4 in experimental group was higher than that in control group,the differences were statistically significant(P<0.05).Conclusion:Xuefu Zhuyu Pills combined with adductor canal block can improve the analgesic effect of total knee arthroplasty patients,effectively inhibit the level of inflammatory factors and reduce the damage of cardiomyocytes,and improve the cardiac function.
曾清明;谢斌;张世杰
赣州市人民医院麻醉科 江西 赣州 341000赣州市立医院药剂科 江西 赣州 341000
全膝关节置换术收肌管阻滞血府逐瘀丸炎症因子心肌保护
Total knee replacementAdductor canal blockXuefu Zhuyu PillsInflammatory factorsMyocardial protection
《中国医学创新》 2024 (019)
67-71 / 5
江西省中医药管理局科技计划项目(2023B0893)
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