人工膝关节置换术后早期应用局部超声药物透入辅助镇痛和功能锻炼的疗效分析  

Analysis of the Effect of Postoperative Functional Training with Local Drug Phonophoresis in Total Knee Arthroplasty

作　　者：及松洁[1] 姜旭[1] 李春敏[1] 程志远[2] 周一新[1] JI Song-jie;JIANG Xu;LI Chun-min(Orthopaedic Department,Beijing Jishuitan Hospital,Beijing 100035)

机构地区：[1]北京积水潭医院矫形骨科,北京100035 [2]北京积水潭医院血管外科,北京100035

出　　处：《医学临床研究》2018年第12期2289-2292,共4页Journal of Clinical Research

基　　金：国家自然科学基金资助项目(81472139).

摘　　要：【目的】探讨人工膝关节置换(TKA)术后早期应用局部超声药物透入辅助镇痛和功能锻炼的效果。【方法】选取2016年6月至2017年5月于本院行单侧TKA患者41例;随机分为观察组21例和对照组20例。两组患者分别给予相同基础镇痛方案;从术后2周起观察组患者辅助局部超声透入药物(利多卡因+倍他米松);4周共10次。随访两组患者至术后3个月;分别记录术前活动度;AKS评分;术后2周;6周;3个月时平均活动度;视觉模拟评分(VAS)和AKS评分。【结果】①两组患者术前的活动度;AKS评分及术后2周的活动度;运动后VAS评分比较差异无统计学意义(P>0.05);②术后6周观察组的活动度为(110.0±12.3)°;VAS为(2.0±1.0)分;对照组为(102.3±10.4)°;VAS为(2.9±1.3)分;两组比较差异有统计学意义(P<0.05);③术后3个月;观察组的活动度为(116.4±10.7)°;AKS功能评分为(84.0±10.6)分;对照组活动度为(111.0±10.9)°;AKS功能评分为(76.0±12.4)分;观察组优于对照组;差异有统计学差异(P<0.05)。【结论】超声药物透入利多卡因和倍他米松能够有效缓解TKA术后疼痛;有助于TKA术后早期疼痛明显的患者的功能康复。【Objective】 To investigate the effect of local drug phonophoresis on pain relief and functional exercise at the early stage after total knee arthroplasty (TKA). 【Methods】 Forty-one patients with unilateral TKA from June 2016 to May 2017 were randomly divided into observation group (n=21) and control group (n=20).Two groups of patients were given the same basic analgesia regimen. From 2 weeks after operation, the patients in the observation group received local ultrasound penetration (lidocaine + betamethasone) for 10 times in 4 weeks. The patients in the two groups were followed up to 3 months after operation. The preoperative activity and AKS scores were recorded respectively. The average activity,visual analogue score (VAS) and AKS score at 2 weeks, 6 weeks and 3 months after operation were recorded respectively. 【Results】 ① There was no significant difference between the two groups in preoperative activity, AKS score, activity at 2 weeks after exercise and VAS score after exercise (P>0.05);② At 6 weeks after operation, the activity of the observation group was (110.0±12.3)°, the VAS score was (2.0±1.0) points, the control group was (102.3±10.4)°,the VAS score was (2.9 ±1.3) points, the difference between the two groups was statistically significant (P<0.05).③ Three months after operation, the activity of the observation group was (116.4±10.7)°, the score of AKS function was (84.0±10.6), the activity of the control group was (111.0±10.9)°, the score of AKS function was (76.0±12.4). The observation group was superior to the control group(P<0.05).【Conclusion】 Ultrasound phonophoresis therapy with lidocaine and betamethasone can effectively relieve postoperative pain after TKA and is helpful to functional rehabilitation of patients with obvious early pain after TKA.

关 键 词：膝关节/外科学 康复 麻醉药 身体锻炼 

分 类 号：R684.76[医药卫生—骨科学]