目的 探讨收肌管阻滞（adductor canal block， ACB）联合腘丛神经阻滞（popliteal plexus block， PPB）应用于关节镜下前交叉韧带重建术（anterior cruciate ligament reconstruction， ACLR）中对患者的影响。 方法 选取2022年3月至2023年11月于本院首次行单侧ACLR治疗患者作为研究对象，根据随机数字表法分为ACB组（n = 48）和联合PPB组（n = 48）；ACB组患者采取ACB，联合PPB组患者采取ACB联合PPB。对比两组患者ACLR后疼痛程度、镇痛情况、不良反应及术后情况。 结果 静息和主动运动状态下，ACLR术后4、8、12、24及48 h，联合PPB组VAS评分均低于ACB组（P < 0.05）；两组ACLR术患者静息和主动运动状态下VAS评分的重复方差分析显示，组别效应F = 162.052/142.173、P = 0.000/0.000，时间效应F = 74.223/65.515、P = 0.000/0.000，交互效应F = 4.707/3.743、P = 0.001/0.007。联合PPB组舒芬太尼累积用量、需要术后补救镇痛次数及膝关节后侧疼痛占比均低于ACB组（P < 0.05）。ACB组与联合PPB组不良反应发生情况对比，差异无统计学意义（P > 0.05）。联合PPB组住院和主动直腿抬高时间均低于ACB组，镇痛满意度评分高于ACB组（P < 0.05）。 结论 ACB联合PPB用于ACLR，可缓解患者术后疼痛，减少舒芬太尼用药及镇痛需求，提高患者满意度，缩短住院及主动直腿抬高时间，促进患者早日康复，且不会增加不良反应发生风险。

Objective To investigate the impact of adductor canal block （ACB） in combination with popliteal plexus block （PPB） on patients undergoing arthroscopic anterior cruciate ligament reconstruction （ACLR）. Methods Patients who underwent primary unilateral ACLR treatment at our hospital between March 2022 and November 2023 were recruited as the research subjects. They were randomly allocated into the ACB group （n = 43 cases） and the combined PPB group （n = 47 cases） using a coin?toss method. Patients in the ACB group received ACB， while those in the combined PPB group received ACB in conjunction with PPB. The pain intensity， analgesic effect， adverse reactions， and postoperative status following ACLR were compared between the two groups. Results The Visual Analogue Scale （VAS） scores of the combined PPB group were significantly lower than those of the ACB group at 4 hours， 8 hours， 12 hours， 24 hours， and 48 hours post ACLR （P < 0.05）. Repeated measures analysis of variance of VAS scores in the resting and active exercise states of ACLR patients in the two groups revealed that the group effect had F?values of 162.052/142.173 and P?values of 0.000/0.000， the time effect had F?values of 74.223/65.515 and P?values of 0.000/0.000， and the interaction effect had an f?value of 4.707/. The cumulative dose of sufentanil， the frequency of postoperative analgesia， and the proportion of posterior knee pain in the combined PPB group were all lower than those in the ACB group （P < 0.05）. There was no significant difference in adverse reactions between the ACB group and the combined PPB group （P > 0.05）. The hospitalization duration and the time to achieve active straight leg raise in the combined PPB group were shorter than those in the ACB group， while the analgesic satisfaction score was higher than that in the ACB group （P < 0.05）. Conclusion The combination of ACB and PPB in ACLR can effectively alleviate postoperative pain， reduce the requirements for sufentanil and analgesic interventions， enhance patient satisfaction， shorten the hospitalization period and the time to achieve active straight leg raise， and promote early patient recovery without increasing the risk of adverse reactions.