文章摘要
向茂英,廖灯彬,宁宁,等.全髋关节置换围手术期静脉应用氢化可的松对术后早期康复疗效的影响.骨科,2021,12(3): 266-270.
全髋关节置换围手术期静脉应用氢化可的松对术后早期康复疗效的影响
Effect of intravenous hydrocortisone during the perioperative period of total hip arthroplasty on early postoperative rehabilitation
投稿时间:2020-10-12  
DOI:10.3969/j.issn.1674-8573.2021.03.014
中文关键词: 关节成形术,置换,髋  氢化可的松  疼痛  早期康复  炎症反应
英文关键词: Arthroplasty, replacement, hip  Hydrocortisone  Pain  Early rehabilitation  Inflammatory response
基金项目:
作者单位E-mail
向茂英 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
廖灯彬 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
宁宁 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
侯晓玲 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
赵丽红 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
李佩芳 四川大学华西医院骨科成都 610041四川大学华西护理学院成都 610041  
康鹏德 四川大学华西医院骨科成都 610041 kangpd@163.com 
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中文摘要:
      目的 探讨全髋关节置换(total hip arthroplasty,THA)围手术期静脉应用氢化可的松对术后早期康复的影响。方法 选取2016年1月至2020年6月在我院行初次单侧THA的病人80例,随机分为氢化可的松组和对照组,每组40例。术前2 h和术后6、14 h,氢化可的松组的病人给予氢化可的松(氢化可的松100 mg/20 mL+生理盐水100 mL)静脉滴注;对照组病人则给予120 mL的生理盐水静脉滴注。观察比较两组病人术后白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平以及疼痛、关节功能、并发症及病人满意度等情况。结果 氢化可的松组术后24、48和72 h的IL-6和CRP水平均显著低于对照组;术后12、24 h的活动疼痛数字评价量表(numeric rating scale,NRS)评分显著低于对照组;术后第1天和第2天的髋关节屈曲活动度和Harris髋关节功能评分均显著优于对照组;术后不同时间点的髋关节外展活动度均显著优于对照组;与对照组比较,差异均有统计学意义(P均<0.05)。与对照组相比,氢化可的松组恶心发生率显著降低、术后住院时间显著缩短、病人满意度评分显著提高,差异均有统计学意义(P均<0.05)。结论 THA围手术期静脉应用氢化可的松有助于加速术后早期康复,值得进一步研究和临床推广。
英文摘要:
      Objective To explore the effect of intravenous hydrocortisone during the perioperative period of total hip arthroplasty (THA) on early postoperative rehabilitation. Methods Totally, 80 patients scheduled to undergo primary, unilateral THA were recruited and randomly divided into hydrocortisone group (40 cases) and control group (40 cases). The patients in hydrocortisone group were given hydrocortisone (100 mg/20 mL hydrocortisone + 100 mL normal saline) 2 h before operation and 6, 14 h after operation. Patients in the control group were given 120 mL normal saline intravenous drip. The postoperative inflammation cytokines [inteleukin-6 (IL-6) and C-reactive protein (CRP)], pain, joint function, complications, and patient satisfaction in the two groups were assessed and compared. Results The levels of IL-6 and CRP in the hydrocortisone group were significantly lower than those in the control group at 24, 48 and 72 h after surgery. The numeric rating scale of 12 and 24 h after operation were significantly lower in the hydrocortisone group than those in the control group. The hip flexion range of motion and Harris hip function score at the first and second day after operation in the hydrocortisone group were significantly better than those in the control group. The hip abduction range of motion at different time points after operation was significantly better in the hydrocortisone group than that in the control group. All the differences were statistically significant between the two groups (all P<0.05). As compared with the control group, the incidence of nausea, and postoperative hospital stay in the hydrocortisone group were significantly reduced (P<0.05), and patient satisfaction score was significantly improved (P<0.05). Conclusion Intravenous hydrocortisone during the perioperative period of THA helps to accelerate early postoperative rehabilitation and is worthy of further research and clinical promotion.
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