经皮神经电刺激技术对全髋关节置换术后疼痛影响的临床研究  

Effect of transcutaneous electrical nerve stimulation.on pain after total hip arthroplasty

作　　者：李伟[1] 王保新 王凯 徐明涛[1] 殷晗[1] 贺新兵[1] LI Wei;WANG Baoxin;WANG Kai;XU Mingtao;YIN Han;HE'Xinbing(Department of Orthopaedics,Liaocheng People's Hospital,Liaocheng 252000 Shandong,China)

机构地区：[1]聊城市人民医院骨科,山东聊城252000

出　　处：《中华骨与关节外科杂志》2020年第3期245-248,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:经皮神经电刺激(TENS)技术对全髋关节置换术(THA)后镇痛效果尚不明确。目的:初步探讨TENS对THA术后疼痛的影响。方法:前瞻性纳入2018年10月至2019年3月拟行初次单侧THA患者100例,采用信封法随机分为TENS组和对照组各50例。TENS组术后第1日开始应用TENS技术直至出院;对照组按同样时间应用,但不产生电流。观察指标:①术后24 h、术后48 h、术后72 h、术后1周及术后2周时患者静息及活动的视觉模拟评分(VAS);②住院期间镇痛补救药物(哌替啶)使用率;③TENS相关不良事件发生率。结果:TENS组4例,对照组3例于术后2周失随访。TENS组患者术后24 h、术后48 h的活动VAS评分明显低于对照组(P<0.05),两组术后72 h、术后1周、术后2周的活动VAS差异无统计学意义(P>0.05),两组术后各时间点的静息VAS差异无统计学意义(P>0.05);TENS组患者术后镇痛补救药物使用率明显低于对照组,差异有统计学意义(P<0.05);两组患者均未发生TENS相关不良事件。结论:TENS可有效减轻THA患者术后1~2 d的活动痛,并有效减少镇痛补救药物用量,是一种安全有效的THA辅助镇痛技术。Background:It is still unclear whether transcutaneous electrical nerve stimulation(TENS)is effective in pain con trol following total hip arthroplasty(THA).Objective:To investigate the effect of TENS on pain control following THA.Meth ods:A total of 100 patients scheduled to undergo primary unilateral THA from October 2018 to March 2019 were enrolled and divided into TENS group and control group(sham TENS-group)randomly with 50 patients in each group.In TENS group,TENS was given to each patient from the first day after THA till discharge.In control group,patients were just operated as the TENS group with electricity shut.The outcome evaluation included the active and resting VAS pain score at 24 h,48 h,72 h,1 week,and 2 week after surgery,the consumption of analgesic rescue medicine(Dolantin)and the incidence of potential TENSrelated adverse events.Results:A total of 4 patients in TENS group and 3 patients in control group were withdrew at 2-week follow-up.The TENS patients had significantly lower active VAS pain scores at 24 h and 48 h after surgery(P<0.05),but the differences were not significant at 72 h,1 and 2 week after surgery(P>0.05);there was no significant differences in resting VAS between two groups at any evaluation time points(P>0.05).The consumption of analgesic rescue medicine in TENS group was significantly lower than that in control group(P<0.05),and there was no TENS-related adverse event in both groups.Con clusions:TENS is a safe and effective analgesic technique for THA,which can significantly control the active pain at 24 h and 48 h after surgery and reduce the consumption of analgesic rescue medicine.

关 键 词：经皮神经电刺激 镇痛 全髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]