加压冷疗装置和一次性冰袋对肩关节镜检术后患者镇痛效果对比分析  

Contrastive analysis of effects between pressure cold therapy and instant ice pack in the pain relief after shoulder arthroscopy

作　　者：孙丽冰 刘洋[1] 刘中砥[1] 张艳[1] 孔祥燕[1] Sun Libing;Liu Yang;Liu Zhongdi;Zhang Yan;Kong Xiangyan(Department of Orthopedics and Traumatology,Peking University People＇s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院创伤骨科北京大学人民医院创伤救治中心,100044

出　　处：《中华肩肘外科电子杂志》2018年第3期214-218,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：卫生公益性行业科研专项(201002014);教育部创新团队项目(IRT-16R01)

摘　　要：目的探讨加压冷疗装置在肩关节镜检术后的镇痛效果,并与一次性冰袋的镇痛效果进行对比分析。方法回顾性分析2016年1月至2017年4月期间在我院创伤骨科因肩关节疾病行关节镜检手术治疗的患者60例,疾病种类包括非复杂性肩袖损伤、冻结肩等。记录所有患者的手术时间,根据患者术后镇痛方式的情况,分为干预组(采用加压冷疗装置)和对照组(采用一次性冰袋)各30例,镇痛治疗的方法均为患肩周围的间断冰敷,每日3次,每次20 min,持续3 d,采用视觉模拟评分法(VAS)评估患者术后镇痛治疗期间的疼痛程度。结果 60例患者的平均手术时间为(65.5±18.47)min,干预组和对照组患者的平均手术时间分别为(62.17±15.96)min和(68.83±20.41)min,术后24、48、72 h干预组与对照组静息疼痛指数的比较差异均有统计学意义(P24h=0.005,P48h=0.002,P72h=0.000);术后24 h干预组与对照组相比,活动疼痛指数差异没有统计学意义(P24h=0.057),术后48 h、72 h两组患者活动疼痛指数差异有显著统计学意义(P48h=0.015,P72h=0.000)。结论加压冷疗装置可有效缓解患肢术后疼痛,操作简便,有利于患者术后早期功能锻炼,促进肩关节功能康复,且便于护理操作,具有很大的临床应用价值,可作为肩关节镜检术后的有效镇痛方案。Background Arthroscopic surgery is a recently developed minimally invasive surgery in China. In addition to treating knee joint problem, arthroscopy can also be used for the diagnosis and treatment of shoulder disease, which has the advantages of small incision, precision procedure, intuition, etc. However, local pain and swelling are still common postoperative problems. Periarticular ice therapy after surgery can promote microvascular contraction, slow down nerve conduction velocity and paralyze local peripheral nerve, which plays the roles in hemostasis, pain relief and detumescence. It can also reduce patient＇s dependence on analgesics and promote wound healing. Conventional cold therapy with ice pack has certain curative effects on postoperative swelling and pain relief, but it has limitations such as high hardness, poor fit with skin, inconvenient fixation, less contact with body surface, etc. Recently, our department has applied a new type of cold therapy device to perform analgesia on the patient with shoulder joint surgery and has achieved good postoperative analgesia effect. Methods 1. Research objects： This study included the patients with shoulder disease who received shoulder arthroplasty at Peking University People＇s Hospital from January 2016 to April 2017. The same screening criteria was used for the inclusion and exclusion of the cases to avoid the influence of different factors on statistical results to the most extent. Inclusive criteria：（1） Patients who received shoulder arthroscopy for various shoulder diseases including rotator cuff tear, shoulder impingement syndrome, frozen shoulder and calcific tendinitis of supraspinatus without gender preference;（2） Patients who cooperated to complete pain assessment with clear consciousness and no communication barrier;（3） Patients who received postoperative analgesia with pressure cold therapy device or disposable ice pack. Exclusive criteria：（1） Combination of severe cardiovascular disease, anemia, hypoproteinemia, diabetes a

关 键 词：肩关节镜 加压冷疗 镇痛 

分 类 号：R473.6[医药卫生—护理学]