全膝关节置换术后10%氯化钠加压冷敷与清水冷敷疗效对比  

Comparing the effects of pressurized salt ice packs with water ice packs on patients following total knee arthroplasty

作　　者：张银昌 王强 董利军 黄德刚 宣华兵 熊寿良 潘丽英 ZHANG Yinchang;WANG Qiang;DONG Lijun;HUANG Degang;XUAN Huabing;XIONG Shouliang;PAN Liying(Department of Joint Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院关节外科,安徽芜湖241001

出　　处：《皖南医学院学报》2019年第1期43-46,共4页Journal of Wannan Medical College

基　　金：皖南医学院中青年科研基金项目(WK2015F17)

摘　　要：目的:比较自制10%氯化钠加压冰袋与清水冰袋冷敷对全膝关节置换术(TKA)后患者镇痛、消肿、减少出血的作用。方法:选取我科2013年1月～2015年8月接受初次单侧全膝关节置换的89例患者,告知患者2种冷敷方法,根据患者的选择分为10%氯化钠加压冰袋组(44例)和清水冰袋组(45例),加压冰袋组采用自制加压冰袋进行冷敷,清水冰袋组采用清水冰袋进行冷敷,测量两组患者术后12、24、48、72 h患肢髌上、髌下5 cm周径并评估疼痛情况;记录术后24 h引流袋引流量。结果:加压冰袋组患者术后12、24、48、72 h疼痛评分均较清水冰袋组低,差异有统计学意义(P<0. 05);加压冰袋组髌上5 cm术后48、72 h肿胀程度优于清水冰袋组,差异有统计学意义(P<0. 05);加压冰袋组髌下5 cm术后12、24、48、72 h肿胀程度优于清水冰袋组,差异有统计学意义(P<0. 05);加压冰袋组较清水冰袋组平均术后24 h引流量减少(P<0. 05)。结论:自制10%氯化钠加压冰袋较清水冰袋更有助于减轻患者疼痛和早期患肢肿胀,减少术后出血,有利于术后康复锻炼。Objective: To compare the effects of pressurized salt ice packs (10% saline,PIP) with water ice packs (WIP)on relieving the pain,swelling and reducing postoperative bleeding in patients following total knee arthroplasty (TKA).Methods: Eighty-nine patients undergone primary unilateral TKA were included from January 2013 to August 2015,and divided into either PIP group( n= 44) or WIP group( n= 45) decided by the patients through informed consent.Visual analog scale (VAS) was used to evaluate knee pain.The girth was measured at 5 cm superior and inferior to the patella for the affected knee and pain scale was recorded at 12,24,48 and 72 h,respectively,after operation,and drainage volume within 24 h after surgery was recorded.Results: The VAS scoring was lower in PIP group than in WIP group at 12,24,48 and 72 h after TKA ( P< 0.05).The swelling at 5 cm superior and inferior to the patella was better improved at 48 and 72 h as well as 12,24,48 and 72 h for the affected knee treated with PIP(all P< 0.05).Patients managed with PIP had lower postoperative drainage volume( P< 0.05).Conclusion: PIP is more effective than WIP on reducing the postoperative pain,swelling and bleeding in patients following total knee arthroplasty,and can contribute to early postoperative rehabilitation exercise.

关 键 词：膝关节置换 加压冷敷袋 出血 镇痛 

分 类 号：R687.4[医药卫生—骨科学]