芒硝外敷治疗全膝关节置换术后膝关节肿痛的临床研究  

Clinical study on external application of natrii sulfas for treatment of knee swelling and pain after total knee arthroplasty

作　　者：毛矛[1] 季卫锋[2] 胡伟龙[1] 苏彪[1] 马镇川[2] 

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江省中医院,浙江杭州310006

出　　处：《中医正骨》2016年第10期7-10,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察芒硝外敷治疗全膝关节置换术后膝关节肿痛的临床疗效。方法:单侧全膝关节置换术后患者60例,随机分为芒硝组与冰敷组,每组30例。术后第1天开始,芒硝组以芒硝500 g装入特制的布袋中外敷患膝,冰袋组以普通医用冰袋(质量500 g)外敷患膝,共敷3 d。分别在术前及术后第1、第2、第3天,采用疼痛视觉模拟量表(visual analogue scale,VAS)对2组患者膝关节疼痛情况进行评估;并测量患膝上、下10 cm处的周长,评估患膝肿胀程度。结果:2组患者膝关节疼痛VAS评分手术前后各时间点间的差异有统计学意义,即存在时间效应(F=73.731,P=0.000);术前和术后第1天,2组患者膝关节疼痛VAS评分的组间差异均无统计学意义[(2.13±0.51)分,(1.90±0.48)分;t=1.829,P=0.073;(3.10±0.31)分,(3.07±0.25)分;t=0.460,P=0.647];术后第2、第3天,芒硝组膝关节疼痛VAS评分均低于冰敷组[(2.23±0.43)分,(3.03±0.49)分;t=-6.719,P=0.000;(1.77±0.57)分,(2.37±0.56)分;t=-4.133,P=0.000];2组间总体比较,芒硝组膝关节疼痛VAS评分低于冰敷组,即存在分组效应[(2.37±0.71)分,(2.82±0.55)分;F=21.353,P=0.000];时间因素和分组因素之间存在交互效应(F=17.594,P=0.000)。术前2组患者膝上、膝下10 cm处周长的组间比较,差异均无统计学意义[(44.03±5.20)cm,(45.53±1.76)cm;t=-1.498,P=0.143;(35.47±3.60)cm,(34.63±1.07)cm;t=1.216,P=0.232];术后2组患者膝上、膝下10 cm处肿胀程度比较,芒硝组均较冰敷组轻[(2.30±0.23)%,(6.71±0.26)%;t=-68.668,P=0.000;(3.10±0.19)%,(8.08±0.14)%;t=-131.325,P=0.000]。结论:对于全膝关节置换术后患者,采用芒硝外敷可有效缓解膝关节疼痛、消除膝关节肿胀,且效果较冰敷好。Objective：To observe the clinical curative effects of external application of natrii sulfas for treatment of knee swelling and pain after total knee arthroplasty （TKA）. Methods：Sixty patients who received unilateral TKA were randomly divided into natrii sulfas group and ice compress group,30 cases in each group. From postoperative day 1, the knees of patients in natrii sulfas group were treated with external application of natrii sulfas,500 g of which filled a special cloth bag, while the knees of patients in ice compress group were treated with external application of common medical ice bags （500 g for each bag）for 3 days. The knee pain degree was evaluated by using visual analogue scale（VAS）before the surgery and at 1,2 and 3 days after the surgery respectively, and the knee swelling degree was evalu- ated by measuring the perimeter of leg at 10 cm above and below the knee. Results ：There was statistical difference in knee pain VAS scores between different time points, in other words, there was time effect （ F = 73.731, P = 0.000）. There was no statistical difference in knee pain VAS scores between the 2 groups before surgery and at postoperative day 1 （2.13 ＋/-0.51 vs 1.90 ＋/-0.48 points,t = 1. 829 ,P =0.073 ; 3.10 ＋/- 0.31 vs 3.07 ＋/- 0.25 points,t = 0. 460, P = 0. 647）. The knee pain VAS scores were lower in natrii sulfas group compared to ice compress group at postoperative day 2 and 3 （ 2.23 ＋/- 0.43 vs 3.03 ＋/- 0.49 points, t = - 6. 719, P = 0. 000 ; 1.77 ＋/- 0.57 vs 2.37 ＋/-0.56 points, t = -4. 133, P = 0. 000）. The knee pain VAS scores were lower in natrii sulfas group compared to ice compress group in general, in other words, there was grouping effect （2.37 ＋/-0.71 vs 2.82 ＋/-0.55 points, F = 21. 353, P ---0.000）. There was in- teraction between time factor and grouping factor（ F = 17. 594, P = 0. 000）. There was no statistical difference in the perimeter of leg at 10 cm above and below the knee between the 2 groups before the surgery（44.03 �

关 键 词：关节成形术 置换 膝 手术后并发症 疼痛 手术后 中药外敷 芒硝 冰敷 

分 类 号：R274.9[医药卫生—中西医结合]