| Objective:To analyze the therapeutic effect of intramedullary injection of analgesia in patients with total hip arthroplasty(THA).Methods:102 patients with THA being treated in Department of Orthopedics of the hospital from September 2014 to December 2016 were taken as the research objects.They were divided into control group(Group A,n=53)in which patients took orally conventional analgesic drugs and the experimental group(Group B,n=49)in which patients were intramedullary injected with analgesic mixture during the operation after taking conventional analgesic drugs.After the operation,blood routine was tested;the levels of platelets(PLT),neutrophils(NEUT)and lymphocyte count(LC)were measured;the NLR and PLR values were calculated.After comparing the results of the two groups,the relativity among different indexes and the significance of NLR and PLR in judging the therapeutic effect were analyzed.Then C-reactive protein(CRP).D-dimmer and partial pressure of carbon dioxide(Pco2)were measured before and after the operation and some general indexes such as the heart rate,respiratory rate and blood pressure before and after the operation were recorded.At different times(12h,24h,48h,72h,lw and 2w after the operation)and follow-up times(1 month and 3 months),VAS scores and hip joint Harris scores were performed in resting and active states and the results were recorded.Barthel score was performed in 1 month and 3 months of follow-up times;the postoperative hip joint movement was recorded;finally,patients’ operation time,total cost of hospitalization and occurrence of adverse reactions and so on were recorded.Results:The ROC curve of PLR of patients.after operation in both groups:the area under the curve(AUC):0.629(P<0.05);sensitivity:0.458;specificity:0.811;tangent value:PLR=194.53.The differences of CRP,D-Dimmer and Pco2 before and after the operation in Group A were significantly higher than those in Group B and the result was statistically significant(P<0.001);The CRP,D-Dimmer and Pco2 value in Group A after the operation were obviously higher than those in Group B(P<0.001).The VAS scores in both groups were statistically different at 12h,24h,48h and 72h after the operation(P<0.05);the Harris scores of Group B after the operation were all higher than those of group A;the Harris scores in both groups at 72h,1w and 2w after the operation and the Barthel scores in 1 month and 3 months of the follow-up were statistically different(P<0.05).The actively movement time of patients in Group B was shorter than that in Group A,and all types of the active time were statistically significant(P<0.05);within 24 hours after the operation,comparing the cases when the flexion degree of the hip joint in active and passive states of both groups reached 45%,it can be found the difference was statistically significant(P<0.05).The differences of respiratory rate,heart rate and blood pressure before and after the operation in Group A were significantly higher than those in Group B(P<0.001);the respiratory rate,heart rate and blood pressure of Group A after the operation were sharply higher than those before the operation(P<0.001).There were no significant differences in the cases of adverse events between the two groups(P>0.05).Conclusion:It can be found that the intramedullary injection of analgesia mixture in patients with THA is safe and reliable without obvious untoward effect and side effects.It can not only effectively reduce the occurrence of deep vein thrombosis of lower limbs,coronary heart disease and other perioperative complications,but also minimize postoperative pain and fear,which is conducive to postoperative rehabilitation exercise. |
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