中西医结合多模式止痛方案改善肩关节镜术后肿胀、疼痛的有效性分析  

Analysis on the effectiveness of multimodal analgesic regimen of integrated medicine in improving swelling and pain after shoulder arthroscopy

作　　者：祝建飞 吕一[1] 李桂锦[1] 陈智能[1] 陈小刚[1] 成锋[1] 郭汝宝[1] ZHU Jianfei;LYU Yi;LI Guijin;CHEN Zhineng;CHEN Xiaogang;CHENG Feng;GUO Rubao(Department of Orthopaedics and Traumatology,the Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学附属第三医院骨伤科,浙江杭州310005

出　　处：《中国现代医生》2022年第16期132-135,139,共5页China Modern Doctor

基　　金：国家自然科学基金面上项目(81873391);浙江中医药大学校级科研基金(2018ZY22)。

摘　　要：目的 探讨中西医结合多模式止痛方案改善肩关节镜术后肿胀、疼痛的有效性。方法 回顾性分析2016年7月~2019年6月浙江中医药大学附属第三医院收治的肩关节镜术后中重度疼痛病例66例,根据中医中药治疗情况分为观察组和对照组各33例。观察组是采用中西医结合多模式止痛方案治疗,对照组采用常规方法治疗。记录患者年龄、性别、体质量指数及手术侧别等资料,观察记录肩关节镜术后关节功能评分情况、测量术前及术后第1、2、14天疼痛视觉模拟评分(VAS)、肢体肿胀增量值及并发症情况,评价分析中西医结合多模式止痛方案改善肩关节镜术后肿胀、疼痛的疗效。结果 观察组治疗优良率为87.88%(29/33),高于对照组的66.67%(22/33),差异有统计学意义(P<0.05);对照组患者术后第1、2、14天VAS疼痛评分数与肿胀增量值均明显高于观察组,差异有统计学意义(P<0.05);两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 关节镜手术疗效确切,虽然属于微创操作,但术后疼痛仍然比较常见,中医药内治法及外治法能在一定程度上辅助改善关节镜术后疼痛,减轻肿胀,具有一定应用前景,值得进一步研究。Objective To explore the effectiveness of multimodal analgesic regimen of integrated medicine in improving swelling and pain after shoulder arthroscopy. Methods A total of 66 patients with moderate to severe pain after shoulder arthroscopy in our hospital from July 2016 to June 2019 were analyzed retrospectively. The patients were divided into the observation group(n =33) and the control group(n =33) according to the treatment of traditional Chinese medicine. The observation group was treated with multimodal analgesic regimen of integrated medicine, and the control group was treated with conventional methods. Data on age, sex, body mass index(BMI), and side of operation were recorded. The joint function score after shoulder arthroscopy, visual analog scale(VAS) of pain, limb swelling increment, and complications on the 1st, 2nd, and 14th day after operation were observed and recorded. The efficacy of multimodal analgesic regimen of integrated medicine in improving swelling and pain after shoulder arthroscopy was evaluated and analyzed. Results The treatment effect of the observation group was excellent in 18 cases, good in 11 cases,qualified in 2 cases, ineffective in 2 cases, and the excellent and good rate of treatment was 87.87%(29/33). The treatment effect of the control group was excellent in 13 cases, good in 9 cases, qualified in 6 cases, ineffective in 5 cases,and the excellent and good rate of treatment was 66.66%(22/33). The excellent and good rate of treatment in the observation group was significantly higher than that in the control group, and the difference had statistical significance(P<0.05). There was no statistically significant difference in the preoperative VAS pain score between the two groups(P>0.05). The VAS pain scores in the control group were higher than those in the observation group at 1, 2, and 14days after surgery, and the difference was statistically significant(P<0.05). The swelling increment value of patients in the control group was significantly higher than that in the observatio

关 键 词：肩关节镜 术后疼痛 术后肿胀 中西医结合 多模式止痛 

分 类 号：R274[医药卫生—中医骨伤科学]