间歇不加压冷疗对全膝关节置换术后患者止痛止血有效性的Meta分析  

Efficacy of intermittent cold therapy without pressure on pain relief and hemostasis after total knee arthroplasty:a Meta analysis

作　　者：陈梦丽[1] 许一吟[1] 徐逸生[1] 孔舒娅 吴茜 CHEN Mengli;XU Yiyin;XU Yisheng;KONG Shuya;WU Qian(Department of Orthopedics,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院骨三科,广州510120

出　　处：《当代护士（上旬刊）》2021年第12期4-8,共5页Modern Nurse

基　　金：广东省中医院刘金文学术经验传承工作室专项基金(粤中医办函〔2017〕17号)。

摘　　要：目的系统评价间歇不加压冷疗对全膝关节置换术后患者在减轻疼痛、减少术口出血等方面的有效性。方法计算机检索PubMed、Embase、Cochrane library、中国生物医学文献数据库、知网学术期刊全文数据库、万方数据资源库、维普中文科技期刊数据库中关于全膝关节置换术后冷疗的随机对照试验。检索时限为建库至2020年8月。由2名研究者对文献质量进行严格评价和资料提取,对符合质量标准的随机对照试验研究通过RevMan 5.3软件进行Meta分析。结果共纳入了8篇临床随机对照研究,样本量共计783例。Meta分析结果显示:间歇不加压冷疗可减轻膝关节置换患者术后24 h的疼痛[MD=-1.76,95%CI(-2.58,-0.94),P<0.00001],术后48 h的疼痛[MD=-1.56,95%CI(-2.53,-0.58),P=0.002],术后72 h的疼痛[MD=-1.42,95%CI(-1.88,-0.96),P<0.00001],术后24 h的伤口引流量[MD=-140.94,95%CI(-276.86,-5.03),P=0.04],差异均具有统计学意义。间歇不加压冷疗对膝关节置换患者术后48 h的伤口引流量的影响与对照组的作用差异不具有统计学意义[MD=-12.14,95%CI(-30.80,6.52),P=0.20]。结论间歇不加压冷疗对膝关节置换术后患者有止痛止血效果,加上该操作简便,易于在临床实施,可供临床实践的参考。Objective To systematically evaluate the effectiveness of intermittent non-pressurized cold therapy in relieving pain and bleeding after total knee arthroplasty.Methods Randomized controlled trials(RCTs)were searched from PubMed,EMBASE,Cochrane library,CBM,CNKI,Wanfang database and VIP journal database.The retrieval time limitation is from the establishment of the database to August 2020.Two researchers evaluated the literature quality strictly and extracted the data.The RCT studies that met the quality standards were meta analyzed by RevMan 5.3 software.Results A total of 8 randomized controlled clinical trials were included,with a total sample size of 783 cases.The results of meta-analysis showed that:intermittent non-pressurized cold therapy could reduce the pain of 24 hours after knee arthroplasty[MD=-1.76,95%CI(-2.58,-0.94),P<0.00001],48 hours of postoperative pain[MD=-1.56,95%CI(-2.53,-0.58),P=0.002],72 hours of postoperative pain[MD=-1.42,95%CI(-1.88,-0.96),P<0.00001],postoperative drainage volume at 24 hours,[MD=-140.94,95%CI(-276.86,-5.03)],The difference was statistically significant(P=0.04).However,there was no significant difference between the two groups about postoperative drainage volume at 48 hours[MD=-12.14,95%CI(-30.80,6.52),P=0.20].Conclusion Intermittent non-pressure cold therapy has analgesic and hemostatic effect on patients after knee arthroplasty.In addition,the operation is simple and easy to implement in clinical practice,which can provide reference for clinical practice.

关 键 词：全膝置换 冷疗 随机对照试验 META分析 

分 类 号：R68[医药卫生—骨科学]