穴位按压联合温灸干预全膝关节置换术后下肢肿胀临床观察  

Clinical Observations on Acupoint Pressing plus Gentle Moxibustion for Intervention in Lower Limb Swelling after Total Knee Arthroplasty

作　　者：陈巧玲[1] 黄双英[1] 封蕾[1] 朱旭霞[1] 沈宋炎 

机构地区：[1]浙江省中医院,杭州310006

出　　处：《上海针灸杂志》2015年第10期990-992,共3页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察穴位按压联合温灸干预全膝关节置换术后下肢肿胀的疗效。方法将120例诊断为膝骨关节炎需行单侧全膝关节置换的患者按手术顺序分为观察组和对照组,每组60例。所有患者术后给予常规护理,包括弹力绷带加压包扎、术肢抬高、早期膝关节制动、局部冰敷、间歇性充气加压,主动的踝泵和股四头肌舒缩锻炼、CPM机械锻炼、弹力袜使用、利伐沙班口服等。观察组术后增加给予穴位按压联合温灸干预。测量记录两组患者术前、手术日及术后第1、3、5、7、14天的双下肢髌骨上下各10 cm处肢体周径;术肢疼痛评分(VAS法);术前及术后第3、7、14天的膝关节屈伸角度(range of mation,ROM)。结果观察组肿胀发生率为47.46%,对照组为67.24%;观察组肿胀持续时间为(7.31±3.19)d,对照组为(10.92±3.12)d;两组患者术后相同时间点的VAS评分、术膝关节活动度等比较差异有统计学意义(P<0.05)。结论穴位按压联合温灸能有效干预全膝关节置换术后下肢肿胀,促进术后膝关节功能恢复。Objective To investigate the therapeutic effect of acupoint pressing plus gentle moxibustion on lower limb swelling after total knee arthroplasty. Method One hundred and twenty patients diagnosed with knee osteoarthritis who required unilateral total knee arthroplasty were allocated, in order of operations, to observation and control groups, 60 cases each. After the operation, all the patients received routine nursing care including elastic bandage pressure dressing, operated-on limb elevation, early knee immobilization, local ice compress, intermittent pneumatic compression, active ankle pump and quadriceps contracting-relaxing exercise, CPM mechanical exercise, use of elastic stockings and oral administration of rivaroxaban. The observation group received postoperative acupoint pressing plus gentle moxibustion additionally. Limb circumferences 10 cm superior and inferior to the patella were measured and operated-on limb pains were scored（using the VAS） in the two groups of patients before, on the day of and at one, three, five, seven and fourteen days after the operation. Knee joint range of motion（ROM） was measured before and at three, seven and fourteen days after the operation. Result The incidence of swelling was 47.46% in the observation group and 67.24% in the control group. The duration of swelling was（7.31 ± 3.19） days in the observation group and（10.92 ± 3.12） days in the control group. There were statistically significant differences in the VAS score and operated-on knee joint range of motion between the two groups of patients at the same time points after the operation（P 0.05）. Conclusion Acupoint pressing plus gentle moxibustion can effectively intervene in lower limb swelling and promote the recovery of knee joint function after total knee arthroplasty.

关 键 词：膝关节 人工 肿胀 点穴疗法 温灸器灸 

分 类 号：R246.2[医药卫生—针灸推拿学]