肩关节镜手术中灌注液温度对患者术后肿胀疼痛及关节功能恢复的影响  

Influence of perfusate temperature in arthroscopic shoulder surgery on postoperative swelling,pain and joint function recovery in the patients

作　　者：胡丽娟 张麟 胡定美 凃峰[1] 范祎 HU Lijuan;ZHANG Lin;HU Dingmei;TU Feng;Fan Yi(Department of Orthopedics,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院骨关节科,湖北武汉430022

出　　处：《西部医学》2024年第8期1166-1169,共4页Medical Journal of West China

基　　金：湖北省自然科学基金项目(2018CFC832)。

摘　　要：目的探究肩关节镜手术中灌注液温度对患者术后肿胀疼痛及关节功能恢复的影响。方法选取武汉市第一医院2020年1月—2022年1月收治的肩关节镜择期手术的患者165例,按随机数表法分为观察组(83例)和对照组(82例)。观察组给予37℃灌注液温度治疗,对照组给予22~24℃灌注液温度治疗。比较两组术后肿胀疼痛情况、美国肩肘外科协会评分(ASES)评分情况、美国加州大学肩关节评分(UCLA)评分情况。结果观察组术后肿胀程度均小于对照组,差异有统计学意义(P<0.05)。两组不同时间点视觉模拟疼痛评分量表(VAS)分值的组间、时间及交互效应差异均有统计学意义(P<0.05);两组术后即刻VAS评分比较差异无统计学意义(P>0.05),术后12、24、48、72 h的VAS评分均较术后麻醉失效即刻呈降低趋势,但观察组降低趋势更显著,差异有统计学意义(P<0.05)。两组不同时间点ASES评分、UCLA评分的组间、时间及交互效应差异均有统计学意义(P<0.05);两组术前ASES分值、UCLA评分比较差异无统计学意义(P>0.05),术后3个月、6个月的ASES评分、UCLA评分均较术前呈上升趋势,但观察组上升趋势更显著,差异均有统计学意义(P<0.05)。结论肩关节镜手术中使用37℃恒温灌注液可减少术后关节肿胀和疼痛,促进患者术后肩关节功能快速恢复。Objective To investigate the influence of perfusate temperature in arthroscopic shoulder surgery on postoperative swelling,pain and joint function recovery in the patients.Methods A total of 165 patients who underwent elective arthroscopic shoulder surgery in Wuhan First Hospital from January 2020 to January 2022 were randomly divided into observation group(83 patients treated with 37℃of perfusate)and control group(82 patients treated with 22℃~24℃of perfusate).Postoperative swelling and pain,the ASES scores,and the UCLA scores were compared between the groups.Results The difference values of arm circumference and shoulder circumference in the observation group immediately after operation and 24h after operation were lower than those in the control group(P<0.05).There were statistically significant differences in VAS scores in terms of inter-group effect,time effect and interaction effect(P<0.05).There was no significant difference in VAS score between the two groups immediately after operation(P>0.05).The VAS scores at 12 h,24 h,48 h and 72 h after operation were lower than those immediately after anesthesia turning negative,but the decrease in the observation group was more significant(P<0.05).There were statistically significant differences in ASES scores and UCLA scores in terms of inter-group effect,time effect and interaction effect(P<0.05).There was no statistically significant difference in ASES score or UCLA score between the two groups before operation(P>0.05).The ASES scores and UCLA scores at 3 months and 6 months after operation were higher than those before operation,but the increase in the observation group was more significant(P<0.05).Conclusion Using perfusate with a constant temperature of 37℃in arthroscopic shoulder surgery can reduce postoperative joint swelling and pain,and promote postoperative shoulder function recovery.

关 键 词：肩关节镜手术 灌注液温度 术后肿胀 疼痛 关节功能 

分 类 号：R68[医药卫生—骨科学]