耳穴贴压在全膝关节置换术后急性疼痛及早期康复中的疗效研究  

Clinical Effects of Auricular Plaster Therapy in Improving Acute Pain after Total Knee Arthroplasty and Early Recovery

作　　者：孔维维 李菊兰[2] 刘帆[3] 安磊磊[3] 张军红 田俊强[3] 尹晓莉[3] KONG Weiwei;LI Julan;LIU Fan;AN Leilei;ZHANG Junhong;TIAN Junqiang;YIN Xiaoli(Nursing College,Lanzhou University,Lanzhou 730030,China;Gansu Provincial Hospital of Traditional Chinese Medicine;Lanzhou University Second Hospital)

机构地区：[1]兰州大学护理学院,甘肃兰州730030 [2]甘肃省中医院 [3]兰州大学第二医院

出　　处：《西部中医药》2020年第12期109-112,共4页Western Journal of Traditional Chinese Medicine

基　　金：兰州市城关区科技计划项目(2018SHFZ0039);兰州大学第二医院“萃英科技创新”计划(CY2017-HL05)。

摘　　要：目的:观察耳穴贴压缓解全膝关节置换术后急性疼痛和促进早期康复的临床疗效。方法:将装有1~80号数字的信封随机分配给入选患者,1~40号患者设置为观察组(耳穴贴压结合多模式镇痛),41~80号患者设置为对照组(多模式镇痛)。所有患者均采用兰州某三甲医院全膝关节置换术多模式镇痛方案。观察组在此基础上取主穴神门、皮质下、交感、内分泌及术区相应的膝穴,配穴胃、脾、肾。疗程为术前1天至术后第7天。每穴每次3 min,每日2次,3天更换1次,两耳交替使用。记录患者术后静息及活动状态疼痛评分、膝关节主动屈伸度、镇痛药物加用情况及首次排气、排便时间。结果:观察组术后第1~7天静息和活动状态疼痛评分均明显低于对照组,第2、3、4天膝关节主动屈伸度优于对照组,按压静脉镇痛泵和加用地佐辛的次数、首次排气和排便时间均少于对照组,差异均具有统计学意义(P<0.05)。结论:耳穴贴压能有效缓解全膝关节置换术后急性疼痛,促进患者关节和胃肠功能的早期康复,减少镇痛药物的使用量,疗效确切。Objective:To observe clinical effects of auricular plaster therapy in improving acute pain after TKA and promoting early recovery.Methods:After distributing the envelopes with number 1 to 80 to the selected patients,the patients with number 1 to 40 were chosen as the observation group(auricular plaster therapy and multimode analgesia),and the patients with number 41 to 80 as the control group(multimode analgesia).All the patients adopted multimode analgesia regimen of TKA in a first class hospital of Lanzhou city.The observation group chose the main acupoints Shenmen(HT7),Pizhixia,Jiaogan,Neifenmi and the corresponding knee points in the surgical region,matching points stomach,spleen and kidney.The course ranged from one day before the surgery and the seventh day after the surgery,three minutes each acupoint each time,twice each day,changed once every three days,two ears alternately.To record pain scores,active flexion and extension of knee joint,analgesics addition,first exhaust time and first defecation time when the patients rested and moved after the operation.Results:The observation group was lower than the control group in pain scores of resting and active state from the first to seventh day after the operation notaly,superior to the control group in active flexion and extension of knee joint at the second,third and forth day,less than the control group in the times of pressing intravenous analgesia pump and adding dezocine,first exhaust time and first defecation time,and the difference had statistical meaning(P<0.05).Conclusion:Auricular plaster therapy could effectively relieve acute pain after TKA,promote early recovery of joint and gastrointestinal function,reduce the usage of analgesic medicines with definite clinical effects.

关 键 词：耳穴贴压 全膝关节置换术 急性疼痛 早期康复 

分 类 号：R687.4[医药卫生—骨科学]