Tải bản đầy đủ (.pdf) (7 trang)

Đánh giá hiệu quả giảm đau sau phẫu thuật thay khớp háng của phương pháp gây tê cơ vuông thắt lưng liên tục dưới hướng dẫn siêu âm

Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (225.29 KB, 7 trang )

73&+ậ1*+,ầ1&8<+&

ẩ1+*,ẩ+,848*,0$86$83+87+877+$<
.+3+ẩ1*&$3+1*3+ẩ3*ặ<7ầ&98é1*7+7
/1*/,ầ17&',+1*'16,ầ8ặ0
9+RjQJ3KQJ1,
Yj+RjQJ9Q7XQ
1

7UQJLKF<+j1L
2

%QKYLQ9LWF

1JKLrQFXQKPPFWLrXiQKJLiWiFGQJJLPDXYjFiFWiFGQJNK{QJPRQJPXQFDSKQJSKiS
Jk\WrOLrQWFFYX{QJWKWOQJGLKQJGQVLrXkPVDXSKXWKXWWKD\NKSKiQJEQKQKkQSKX
WKXWWKD\NKSKiQJWKHRFKQJWUuQKFFJLPDXVDXPEQJSKQJSKiSJk\WrFYX{QJWKW
OQJOLrQWFGLKQJGQFDVLrXkPWL7UXQJWkP*k\PrYj+LVFQJRRLNKRD%QKYLQ9LWFW
WKiQJQWKiQJQP7KLJLDQWKFKLQNWKXWYQJSKRQJEFPJLiFLPDX9$6NKLQJKYj
NKLYQQJPFKjLOzQJFDEQKQKkQYjVOQJPRUSKLQWLrXWKYjPWVWiFGQJNK{QJPRQJPXQ
FJKLOLWURQJJLVDXP7KLJLDQWKFKLQNWKXWWUXQJEuQKOj SK~W
QJ́͵LE͟QK
SKRQJE͗ÿ́ͻFWK̿QNLQKFKͅXE͑QFKͅXK̹YͣSKRQJE͗ÿ́ͻFWK̿QNLQKÿLYjWK̿QNLQKEuÿLQJRjL
SKRQJE͗ÿ́ͻFWK̿QNLQKVLQKGͽFÿLYjSKRQJE͗ÿ́ͻFWK̿QNLQKEͣWĈL͛P9$6WUXQJEuQKNKLQJK͡
ÿ͙XYjNKLYͅQÿͱQJÿ͙X[̽S[͡ͷW̽WF̻FiFWK͵LÿL͛P&yE͟QKQKkQSK̻LJL̻LF΁XE͉QJPRUSKLQYͳLWͭQJ
OL͙XPJYjE͟QKQKkQFyP΁FÿͱKjLOzQJYjU̽WKjLOzQJ1JKLrQF΁XFͿDFK~QJW{LFKRWK̽\Jk\WrF˿
YX{QJWK͇WOLrQWͽFǴͳLḰͳQJG̓QVLrXkPFyKL͟XTX̻JL̻PÿDXWͩWVDXPͭFKRFiFSK̓XWKXͅWWKD\NKͳSKiQJ
7ӯNKyDJk\WrFѫYX{QJWKҳWOѭQJWKD\NKӟSKiQJKѭӟQJGүQFӫDVLrXkPJLҧPÿDXVDXPә

,ĈҺ79Ҩ1Ĉӄ
ĈDXVDXSKүXWKXұWWKD\NKӟSKiQJ 7.+



Fy PӭF ÿӝ Wӯ YӯD ÿӃQ QһQJ ÿһF ELӋW ÿDX ӣ
PӭFÿӝUҩWQKLӅXWURQJJLӡSKүXWKXұWÿҫX
WLrQĈӇJLҧPÿDXVDXSKүXWKXұWFKLGѭӟLQyL
FKXQJYjSKүXWKXұWNKӟSKiQJQyLULrQJWUrQ
WKӃJLӟLÿmFyQKLӅXSKѭѫQJSKiSÿѭӧFQJKLrQ
FӭX QKѭ JLҧP ÿDX WRjQ WKkQ TXD ÿѭӡQJ WƭQK
PҥFK 3&$
Jk\WrQJRjLPjQJFӭQJ 10&

OLrQ WөF Yj Jk\ Wr WKkQ WKҫQ NLQK 7.
 QJRҥL
YL  *ҫQ ÿk\ WUrQ WKӃ JLӟL Jk\ Wr Fѫ YX{QJ
WKҳW OѭQJ Oj SKѭѫQJ SKiS PӟL ÿDQJ UҩW ÿѭӧF
TXDQ WkP QJKLrQ FӭX *k\ Wr Fѫ YX{QJ WKҳW
OѭQJOҫQÿҫXWLrQÿѭӧFP{WҧWURQJQăP
7iFJL̻OLrQK͟9NJ+RjQJ3Ḱ˿QJ
7Ú͵QJĈ̹LKͥF<+j1ͱL
(PDLOYXKRDQJSKXRQJ#KPXHGXYQ
1Jj\QKͅQ

EӣL%ODQFRYj0F'RQQHOOYjÿѭӧFFiFWiFJLҧ
VDX ÿy P{ Wҧ U} KѫQ YӅ PһW Nƭ WKXұW  7iF
JLҧ3DUUDVYj%ODQFRJҫQÿk\ÿmEiRFiRYLӋF
Vӱ GөQJ SKѭѫQJ SKiS Jk\ Wr Fѫ YX{QJ WKҳW
OѭQJQKѭOjPӝWOӵDFKӑQWKD\WKӃFKRJk\Wr
WKҫQNLQKÿLÿӇJLҧPÿDXKұXSKүXVDXSKүX
WKXұW WKD\ NKӟS KiQJ6 7iF JLҧ 8HVKLPD JҫQ
ÿk\FNJQJÿmEiRFiRKLӋXTXҧWiFGөQJJLҧP
ÿDX EҵQJ SKѭѫQJ SKiS Jk\ Wr Fѫ YX{QJ WKҳW

OѭQJ OLrQ WөF FKR SKүX WKXұW WKD\ NKӟS KiQJ
WRjQEӝ 7.+7%
7Ӣ9LӋW1DPSKѭѫQJSKiS
Jk\WrFѫYX{QJWKҳWOѭQJYүQFzQOjPӝWYҩQ
ÿӅ PӟL FKѭD Fy QKLӅX QJKLrQ FӭX YӅ YҩQ ÿӅ
Qj\ &KtQK Yu Yұ\ FK~QJ W{L WLӃQ KjQK QJKLrQ
FӭX ÿӅ WjL ³ĈiQK JLi KLӋX TXҧ JLҧP ÿDX VDX
SKүXWKXұWWKD\NKӟSKiQJFӫDSKѭѫQJSKiS
Jk\WrFѫYX{QJWKҳWOѭQJOLrQWөFGѭӟLKѭӟQJ
GүQVLrXkP´

1Jj\ÿ́ͻFFK̽SQKͅQ

TCNCYH 138 (2) - 2021




73&+ậ1*+,ầ1&8<+&

,,,71*9ơ3+1*3+ẩ3
LWQJ
&iF EQK QKkQ QJKLrQ FX Fy  WXL  
NK{QJFyFKQJFKQKJk\WrYQJYjFy
FKQKSKXWKXWWKD\NKSKiQJWKHRFKQJ
WUuQKWL7UXQJWkP*k\PrYjKLVFQJRLNKRD
%QKYLQ9LWFWWKiQJQP
%QK QKkQ Eӏ ORҥL WUӯ UD NKӓL QJKLrQ FӭX EDR
JӗPQKLӉPWUQJWҥLYQJFKӑFNLPGӏӭQJWKXӕF
WrUӕLORҥQÿ{QJPiXQJѭӡLEӋQKUӕLORҥQWkP

WKҫQNKyNKăQJLDRWLӃSEӋQKQKkQKRһFQJѭӡL
JLiPKӝNK{QJÿӗQJêWKDPJLDQJKLrQFӭX
3KѭѫQJSKiS
7KL͗WN͗QJKLrQF΁XWKӱQJKLӋPOkPVjQJ
 &͹ P̓X 7ҩW Fҧ EӋQK QKkQ ÿiS ӭQJ ÿӫ
WLrX FKXҭQ OӵD FKӑQ ÿѭӧF WKX WKұS WURQJ
NKRҧQJ WKӡL JLDQ QJKLrQ FӭX  EӋQK QKkQ
ÿѭӧF WKӵF KLӋQ YӟL SKѭѫQJ SKiS Jk\ Wr Jk\
WrFѫYX{QJWKҳWOѭQJOLrQWөFGѭӟLKѭӟQJGүQ
FӫDVLrXkP
&iFÉͳFWL͗QKjQKQJKLrQF΁X
 &KXҭQ Eӏ %1 Yj SKѭѫQJ WLӋQ Jk\ Wr %1
ÿѭӧF WKăP NKiP WUѭӟF Pә JLҧL WKtFK YӅ Nӻ
WKXұWJk\WrFiFELӃQFKӭQJFyWKӇ[ҧ\UDYjNê
JLҩ\ÿӗQJêWKDPJLDQJKLrQFӭXÿѭӧFKѭӟQJ
GүQFiFKÿiQKJLiPӭFÿӝÿDXWKHRWKDQJÿLӇP
9$6Pi\VLrXkPYӟLÿҫXGzSKҷQJFyWҫQ

0+]FӫDKmQJ*(+HDOWKFDUHNLPJk\Wr
WKҫQNLQKFyOXӗQFDWKHWHUWKXӕFWr5RSLYDFDLQ
 $VWUD=HQHFD
YjFiFWKXӕFFҩSFӭX
 .ƭ WKXұW Jk\ Wr Fѫ YX{QJ WKҳW OѭQJ GѭӟL
KѭӟQJGүQFӫDVLrXkP
%ӋQKQKkQӣWѭWKӃQҵPQJKLrQJYӅSKtD
ErQOjQKEӝFOӝYQJWKҳWOѭQJErQSKүXWKXұW
%iFVƭUӱDWD\PһFiRÿLJăQJY{NKXҭQViW
WUQJYQJFKӑFNLPYjWUҧLWRDQY{NKXҭQ
 'QJ ÿҫX Gz VLrX kP WKҷQJ WҫQ Vӕ FDR
0+]ÿҫXGzÿһWӣYQJWKҳWOѭQJQJDQJ

UӕQWuPKuQKҧQKOӟSFѫWKjQKEөQJWLӃSWөF
GL FKX\ӇQ ÿҫX Gz WKHR PһW SKҷQJ FҳW QJDQJ
ӣSKtDWUrQPjRFKұXUӗLWUѭӧWUDVDXÿӃQNKL
WKҩ\WRjQEӝFѫYX{QJWKҳWOѭQJ
+~WYjEѫPPOGXQJGӏFKQDWULFORULGÅ
ÿӇWiFKFiFOӟSPҥF[iFÿӏQKÿӝVkXFӫDNLP
WrYjOXӗQFDWKHWHUYjRNKRDQJKѭӟQJYӅYӏWUt
4/VkXNKRҧQJFP+~WWKӱFDWKHWHUQӃX
NK{QJFyPiXFKҧ\UDEѫPPO/LGRFDLQ
TXD FDWKHWHU YjR NKRDQJ Fѫ YX{QJ WKҳW OѭQJ
NLӇPWUDVӵODQWRҧWKXӕFWrGѭӟLVLrXkP
6DXSKүXWKXұWNKLKӃWWiFGөQJFӫDWKXӕF
WrWӫ\VӕQJYjÿLӇP9$6!WLrPOLӅXEROXVEҵQJ
GXQJGӏFK5RSLYDFDLQPO*LҧPÿDXEҵQJ
GXQJGӏFKKӛQKӧSURSLYDFDLQIHQWDQ\O
PFJPOEROXVPOFiFKQKDXPӛLKYjGX\WUu
YӟLWӕFÿӝPOKÿLӅXFKӍQKWKHRÿLӇP9$6

&ѫFKpR

&ѫFKpRQJRjL
+ѭӟng

&ѫQJDQJEөng

&ѫYX{QJWKҳt

+uQK*k\WrFѫYX{QJWKҳWOѭQJGѭӟLKѭӟQJGүQVLrXkP



TCNCYH 138 (2) - 2021


7Ҥ3&+Ë1*+,Ç1&Ӭ8<+Ӑ&
 7LrX FKt ÿiQK JLi KLӋX TXҧ JLҧP ÿDX
VDXPә
 7KӡL JLDQ WKӵF KLӋQ Nƭ WKXұW WәQJ OLӅX
WKXӕFWr
9QJSKRQJEӃFҧPJLiF
 ĈLӇP ÿDX 9$6 NKL QJKӍ QJѫL Yj NKL YұQ
ÿӝQJWҥLFiFWKӡLÿLӇP
0ӭFÿӝKjLOzQJFӫDEӋQKQKkQYjOѭӧQJ
PRUSKLQWLrXWKөWURQJK
&iFWiFGөQJNK{QJPRQJPXӕQӬFFKӃ
YұQ ÿӝQJ FKӑF YjR PҥFK PiX OӋFK Yӏ WUt Wr
Q{QEXӗQQ{QQJӭDEtWLӇXUXQ«
;ӱOêVӕOLӋX
6ӱGөQJSKҫQPӅPWKӕQJNr63669ӟL

FiFELӃQÿӏQKOѭӧQJGQJWKXұWWRiQWVWXGHQW
9ӟL FiF ELӃQ ÿӏQK WtQK Ȥ2 KRһF )LVKHU QӃX !
Vӕ{EҧQJ[FyWҫQVXҩWOêWKX\ӃW

6ӵNKiFELӋWFyêQJKƭDWKӕQJNrNKLS
ĈҥRÿӭFQJKLrQFӭX
1JKLrQFӭXÿѭӧFWK{QJTXDKӝLÿӗQJQJKLrQ
FӭXNKRDKӑFFӫD%ӝP{Q*k\PrKӗLVӭFYj
KӝL ÿӗQJ ÿiQK JLi ÿӅ FѭѫQJ QJKLrQ FӭX FӫD
7UѭӡQJĈҥLKӑF<+j1ӝLEDQOmQKÿҥR7UXQJ
WkP*k\PrYjKӗLVӭFQJRҥLNKRD%ӋQKYLӋQ

9LӋW ĈӭF +ӗ Vѫ Yj FiF WK{QJ WLQ OLrQ TXDQ
FKӍ ÿѭӧF Vӱ GөQJ FKR PөF ÿtFK QJKLrQ FӭX
NK{QJ WLӃW Oӝ FKR EҩW Nu ÿӕL WѭӧQJ NK{QJ OLrQ
TXDQQjRNKiF

,,,.ӂ748Ҧ
0ӝWVӕÿһFÿLӇPFKXQJ
%ҧQJ 3KkQEӕÿһFÿLӇPFKXQJ
ĈһFÿLӇPFKXQJ

;“6'

7XәL QăP


“

*LӟL 1DPQӳ
 Q




&KLӅXFDR FP


“

&kQQһQJ NJ



“

7KӡLJLDQSKүXWKXұW SK~W


“

6ӕOҫQFKӑFNLP OҫQ


“

6ӕOҫQOXӗQFDWKHWHU OҫQ


“

7KӡLJLDQWKӫWKXұW SK~W


“

7KӡLJLDQWKӵFKLӋQWKӫWKXұWWUXQJEuQKOjNKRҧQJ SK~W
YjKҫXKӃW%1FKӍWKӵFKLӋQOҫQ
OjWKjQKF{QJ

TCNCYH 138 (2) - 2021





7Ҥ3&+Ë1*+,Ç1&Ӭ8<+Ӑ&
9QJSKRQJEӃFҧPJLiFVDXOLӅXEROXVÿҫXWLrQ

%



ϭϬϬ





ϵϬ
ϴϬ



ϳϬ

ϲϬ



ϱϬ
ϰϬ
ϯϬ
ϮϬ

ϭϬ
Ϭ

9QJSKRQJEӃFҧPJLiF
7.ÿL

7.ÿLELQJRjL

7.EӏW

7.FKұXEҽQ FKұXKDYӏ

7.VLQKGөFÿL

%LӇXÿӗ3KkQEӕYQJSKRQJEӃFҧPJLiFQKyP4/
7URQJQJKLrQFӭXFӫDFK~QJW{LQJѭӡLEӋQKÿӅXSKRQJEӃÿѭӧFWKҫQNLQKFKұXEҽQFKұX
KҥYӏSKRQJEӃÿѭӧFWKҫQNLQKÿLYjWKҫQNLQKEuÿLQJRjLFySKRQJEӃÿѭӧFWKҫQ
NLQKVLQKGөFÿLYjSKRQJEӃWKҫQNLQKEӏW

9$6

+LӋXTXҧJLҧPÿDX
ϭϬ
ϵ
ϴ
ϳ
ϲ
ϱ
ϰ
ϯ

Ϯ
ϭ
Ϭ

<ŚŝǀҨŶĜҾŶŐ
ϲ͕Ϭϭ

ϰ͕ϱϬ

ϰ͕ϰϯ

ϰ͕ϲϳ

ϰ͕ϯϳ

<ŚŝŶŐŚҶ

ϰ͕ϯϯ

ϰ͕Ϭϯ

ϰ͕Ϭϳ

ϰ͕Ϭϳ

ϯ͕ϱϬ

ϯ͕Ϭϳ

ϰ͙

Ϯ͘ϳϬ
+

+

Ϯ͕ϭϬ
+

Ϯ͕ϰϯ
+

Ϯ͕ϯϬ
+

Ϯ͕Ϭϳ
+

ϭ͕ϲϳ

ϭ͕ϵϯ
+

+

ϭ͕ϳϯ
+

ϭ͕ϮϬ Ϭ͕ϴϯ
+


+

&iFWKӡLÿLӇPQJKLrQFӭX
%LӇXÿӗĈLӇPÿDX9$6WƭQKYjÿӝQJӣFiFWKӡLÿLӇPQJKLrQFӭX
7ҩWFҧ%1WURQJQJKLrQFӭXVDXSKүXWKXұW WҥLWKӡLÿLӇP+
ÿӅXFyPӭFÿӝÿDXQKLӅX 9$6
WUXQJEuQK!
.KLQJKӍWҥLFiFWKӡLÿLӇPQJKLrQFӭXWURQJJLӡVDXPәÿLӇP9$6WUXQJEuQK
FKӍӣPӭFÿӝÿDXtW 9$6
ӢFiFWKӡLÿLӇPNKLEӋQKQKkQWұSYұQÿӝQJÿLӇP9$6WUXQJEuQKWҥL
FiFWKӡLÿLӇPQJKLrQFӭXÿӅXJLҧPVRYӟLWKӡLÿLӇP+ 9$6JҫQQKѭӣPӭF

×