多模式消肿方案在全膝关节置换术后的早期疗效分析  

An Early Efficacy Analysis of Multimodal Swelling Reduction Regimen After Total Knee Arthroplasty

作　　者：邓海峰 邓长弓[2] 王星宽 李青松 陈路[1] Deng Haifeng;Deng Changgong;Wang Xingkuan(Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000;North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院骨科,四川南充637000 [2]川北医学院,四川南充637000

出　　处：《四川医学》2024年第12期1345-1351,共7页Sichuan Medical Journal

基　　金：南充市2023年市级科技研发计划(编号:23JCYJPT0036)。

摘　　要：目的探究在全膝关节置换手术围术期中应用多模式消肿方案的早期疗效。方法一项随机、双盲、前瞻性试验分析,选择我院2023年11月至2024年5月收治的膝关节骨关节炎患者90例,均接受全膝关节置换治疗,其中标准治疗组(A组,n=30)在术中局部注射和术后静脉滴注地塞米松,试验B组(B组,n=30)围术期应用地塞米松联合术后应用七叶皂苷钠,试验C组(C组,n=30)围术期应用地塞米松联合术后应用七叶皂苷钠、硫酸镁湿敷。观察指标有:肢体周径测量、肿胀率、膝关节目测类比评分(VAS)、膝关节活动度、隐性失血量计算、炎症指标、营养指标。结果术后第4天肢体周径大小C组低于A组、B组(P<0.05);术后肢体肿胀率C组低于A组、B组(P<0.05);术后第3天膝关节目测类比评分C组低于A组(P<0.05);术后第4天膝关节目测类比评分C组低于A组、B组(P<0.05),B组低于A组(P<0.05);术后第3天膝关节活动度C组高于A组(P<0.05);术后第4天膝关节活动度C组高于A组、B组(P<0.05),B组高于A组。结论在全膝关节置换术围术期应用地塞米松联合术后应用七叶皂苷钠静脉滴注和硫酸镁外湿敷,能有效缓解患者术后膝关节早期肿胀,促进患者膝关节功能康复,减少患肢疼痛。Objective This article explores the early efficacy of the application of a multimodal swelling reduction regimen in the perioperative period of total knee arthroplasty.Methods A randomized,double-blind,prospective experimental analysis selected 90 patients with knee osteoarthritis admitted to our hospital from November 2023 to May 2024.All patients received total knee arthroplasty,among which group A(n=30)was treated with intraoperative local injection and postoperative intravenous infusion of dexamethasone,dexamethasone was applied in group B(n=30)combined with escin sodium in the perioperative period,and dexamethasone was applied in group C(n=30)combined with escin sodium and magnesium sulfate wet compress in the perioperative period.The observed indicators:limb circumference measurement,swelling rate,knee joint visual analogue scale,knee joint range of motion,recessive blood loss calculation,inflammatory index,and nutritional index.Results On the fourth day after surgery,the limb circumference size of group C was lower than that of group A and group B(P<0.05).The rate of limb swelling of group C was lower than that of group A and group B(P<0.05).On the third day after surgery,the knee joint visual analogue scale of group C was lower than that of group A(P<0.05),and the knee joint visual analogue scale of group C on the fourth day after surgery was lower than that of group A and group B(P<0.05),and group B was lower than group A(P<0.05).On the third day after surgery,the knee range of motion of C group was higher than that of group A(P<0.05).On the fourth day after surgery,the knee range of motion of group C was higher than that of group A and group B(P<0.05),and group B was higher than group A.Conclusion The application of dexamethasone in perioperative period combined with internal infusion of escin sodium and external wet compress of magnesium sulfate after total knee arthroplasty can effectively alleviate the early swelling of the knee joint after surgery,promote the rehabilitation of knee joint function,re

关 键 词：全膝关节置换术 消肿止痛 七叶皂苷 硫酸镁 疼痛 

分 类 号：R684[医药卫生—骨科学]