间断冷疗对人工全膝关节置换术后肿痛及关节活动度的疗效观察

发布时间：2018-05-24 22:21

  本文选题：冷疗 + 镇痛　； 参考：《郑州大学》2017年硕士论文

【摘要】：目的:观察间断冷疗在人工膝关节置换术后肿痛及关节活动度的疗效。方法:60例单侧人工膝关节置换(TKA)病人随机分为试验组30例和对照组30例,试验组术中关节周围注射“鸡尾酒”,硬膜外镇痛泵自控及口服非甾体抗炎药镇痛,术后冰袋间断冷疗,对照组不给于冰袋冷疗,余治疗及功能锻炼与治疗组相同,分别记录术前、术后6h、24h、48h、72h的运动痛评分(VAS),膝关节术前、术后1d、2d、3d、1w的关节活动度(Range of Motion,ROM值),术后6h、24h、48h所有血性引流液总量(ml),术后并发症及患者满意度。结果:通过对两组患者术前、术后不同时间点运动VAS值变化情况分析比较,两者组内比较,较术前差异有统计学意义(P0.05),说明镇痛方案选择有效,可减低TKA术后疼痛评分;而试验组与对照组比较,而冷疗组疼痛改善较明显,二者比较有统计学意义,这说明冷疗在镇痛方面效果显著。?两组患者术后不同时间点关节活动度比较,两组组内比较,差异有统计学意义(P0.05),这说明早期镇痛效果显著,关节及早得到有效地功能锻炼,膝关节活动范围增大;而试验组膝与照组比较试验组优于对照组,二者比较有统计学意义(P0.05),说明间断冷疗可改善膝关节早期活动度。?通过对两组术后6h、24h、48h引流量的分析,二者比较试验组优于对照组,二者有统计学意义(P0.05)。(4)通过对两组患者副反应分析,试验组无明显相关并发症出现,说明间断冷疗并不增加不良反应的发生率。(5)两组满意率比较,试验组满意率为93.33%,对照组满意率为83.33%,差异有统计学意义,说明间断冷疗可提高患者的满意度。结论:间断冷疗可有效改善人工全膝关节术后疼痛、肿胀程度,改善关节活动度,具有不良反应小,临床满意度高的优势,具有成本低廉,操作简单,疗效确切,值得在TKA术后推荐应用。
[Abstract]:Objective: to observe the effect of intermittent cold therapy on pain and swelling after artificial knee arthroplasty. Methods Sixty patients with TKAwere randomly divided into the experimental group (n = 30) and the control group (n = 30). In the experimental group, "cocktails" were injected around the joints during the operation, the epidural analgesia pump was self-controlled and the non-steroidal anti-inflammatory drugs were taken orally. The patients in the control group were not given ice bag cold therapy. The remaining treatment and functional exercise were the same as those in the treatment group. The motor pain scores of preoperative and postoperative 6 hours, 24 hours, 48 hours and 72 hours after operation were recorded respectively, and before knee joint operation, the scores of motor pain were recorded. The range of motion ROM was measured at 1 day, 2 days and 3 days after operation. The total amount of all blood drainage fluid was 24 hours and 48 hours after operation. The postoperative complications and patients' satisfaction were observed. Results: the changes of VAS at different time points before and after operation were analyzed and compared between the two groups. The difference between the two groups was statistically significant (P 0.05), which indicated that the choice of analgesic scheme was effective and could reduce the postoperative pain score of TKA. The experimental group compared with the control group, but the cold treatment group pain improvement is more obvious, the two comparison has statistical significance, which shows that cold therapy in analgesic effect is significant. The difference between the two groups at different time points after operation was statistically significant (P 0.05), which indicated that the early analgesia effect was significant, the joint got effective functional exercise early, and the range of knee joint movement was enlarged. The knee in the experimental group was better than that in the control group, and there was a significant difference between the two groups (P 0.05), which indicated that intermittent cold therapy could improve the early motion of the knee joint. According to the analysis of the drainage flow at 6 hours and 24 hours after operation, the two groups were better than the control group, and the two groups had statistical significance (P 0.05). The side effects of the two groups were analyzed, and there were no related complications in the trial group. The satisfaction rate of the two groups was 93.33 and 83.33, respectively. The difference was statistically significant, which indicated that intermittent cold therapy could improve the satisfaction of the patients. Conclusion: intermittent cold therapy can effectively improve the degree of pain, swelling, joint motion, low adverse reaction, high clinical satisfaction, low cost, simple operation and accurate curative effect after total knee arthroplasty. It is recommended to be used after TKA.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
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本文编号：1930827