[1]毛矛,季卫锋,胡伟龙,等.芒硝外敷治疗全膝关节置换术后膝关节肿痛的临床研究[J].中医正骨,2016,28(10):7-10.
　MAO Mao,JI Weifeng,HU Weilong,et al.Clinical study on external application of natrii sulfas for treatment of knee swelling and pain after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(10):7-10.
点击复制

芒硝外敷治疗全膝关节置换术后膝关节肿痛的临床研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年10期
页码:
7-10
栏目:
临床研究
出版日期:
2016-10-20

文章信息/Info

Title:
Clinical study on external application of natrii sulfas for treatment of knee swelling and pain after total knee arthroplasty
作者:
毛矛1; 季卫锋2; 胡伟龙1; 苏彪1; 马镇川2
1.浙江中医药大学,浙江 杭州 310053;
2.浙江省中医院,浙江 杭州 310006
Author(s):
MAO Mao1; JI Weifeng2; HU Weilong1; SU Biao1; MA Zhenchuan2
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.Zhejiang Provincial Hospital of TCM,Hangzhou 310006,Zhejiang,China
关键词:
关节成形术; 置换; 膝;  手术后并发症;  疼痛; 手术后;  中药外敷;  芒硝;  冰敷
Keywords:
arthroplasty; replacement; knee;  postoperative complications;  pain; postoperative;  external applications(TCD);  natrii sulfas;  ice compress
摘要:
目的:观察芒硝外敷治疗全膝关节置换术后膝关节肿痛的临床疗效。方法:单侧全膝关节置换术后患者60例,随机分为芒硝组与冰敷组,每组30例。术后第1天开始,芒硝组以芒硝500 g装入特制的布袋中外敷患膝,冰袋组以普通医用冰袋(质量500 g)外敷患膝,共敷3 d。分别在术前及术后第1、第2、第3天,采用疼痛视觉模拟量表(visual analogue scale,VAS)对2组患者膝关节疼痛情况进行评估; 并测量患膝上、下10 cm处的周长,评估患膝肿胀程度。结果:2组患者膝关节疼痛VAS评分手术前后各时间点间的差异有统计学意义,即存在时间效应(F=73.731,P=0.000); 术前和术后第1天,2组患者膝关节疼痛VAS评分的组间差异均无统计学意义[(2.13±0.51)分,(1.90±0.48)分; t=1.829,P=0.073;(3.10±0.31)分,(3.07±0.25)分; t=0.460,P=0.647]; 术后第2、第3天,芒硝组膝关节疼痛VAS评分均低于冰敷组[(2.23±0.43)分,(3.03±0.49)分; t=-6.719,P=0.000;(1.77±0.57)分,(2.37±0.56)分; t=-4.133,P=0.000]; 2组间总体比较,芒硝组膝关节疼痛VAS评分低于冰敷组,即存在分组效应[(2.37±0.71)分,(2.82±0.55)分; F=21.353,P=0.000]; 时间因素和分组因素之间存在交互效应(F=17.594,P=0.000)。术前2组患者膝上、膝下10 cm处周长的组间比较,差异均无统计学意义[(44.03±5.20)cm,(45.53±1.76)cm; t=-1.498,P=0.143;(35.47±3.60)cm,(34.63±1.07)cm; t=1.216,P=0.232]; 术后2组患者膝上、膝下10 cm处肿胀程度比较,芒硝组均较冰敷组轻[(2.30±0.23)%,(6.71±0.26)%; t=-68.668,P=0.000;(3.10±0.19)%,(8.08±0.14)%; t=-131.325,P=0.000]。结论:对于全膝关节置换术后患者,采用芒硝外敷可有效缓解膝关节疼痛、消除膝关节肿胀,且效果较冰敷好。
Abstract:
Objective:To observe the clinical curative effects of external application of natrii sulfas for treatment of knee swelling and pain after total knee arthroplasty(TKA).Methods:Sixty patients who received unilateral TKA were randomly divided into natrii sulfas group and ice compress group,30 cases in each group.From postoperative day 1,the knees of patients in natrii sulfas group were treated with external application of natrii sulfas,500 g of which filled a special cloth bag,while the knees of patients in ice compress group were treated with external application of common medical ice bags(500 g for each bag)for 3 days.The knee pain degree was evaluated by using visual analogue scale(VAS)before the surgery and at 1,2 and 3 days after the surgery respectively,and the knee swelling degree was evaluated by measuring the perimeter of leg at 10 cm above and below the knee.Results:There was statistical difference in knee pain VAS scores between different time points,in other words,there was time effect(F=73.731,P=0.000).There was no statistical difference in knee pain VAS scores between the 2 groups before surgery and at postoperative day 1(2.13+/-0.51 vs 1.90+/-0.48 points,t=1.829,P=0.073; 3.10+/-0.31 vs 3.07+/-0.25 points,t=0.460,P=0.647).The knee pain VAS scores were lower in natrii sulfas group compared to ice compress group at postoperative day 2 and 3(2.23+/-0.43 vs 3.03+/-0.49 points,t=-6.719,P=0.000; 1.77+/-0.57 vs 2.37+/-0.56 points,t=-4.133,P=0.000).The knee pain VAS scores were lower in natrii sulfas group compared to ice compress group in general,in other words,there was grouping effect(2.37+/-0.71 vs 2.82+/-0.55 points,F=21.353,P=0.000).There was interaction between time factor and grouping factor(F=17.594,P=0.000).There was no statistical difference in the perimeter of leg at 10 cm above and below the knee between the 2 groups before the surgery(44.03+/-5.20 vs 45.53+/-1.76 cm; t=-1.498,P=0.143;35.47+/-3.60 vs 34.63+/-1.07 cm; t=1.216,P=0.232).The postoperative swelling degree of leg at 10 cm above and below the knee was slighter in natrii sulfas group compared to ice compress group(2.30+/-0.23 vs 6.71+/-0.26%; t=-68.668,P=0.000; 3.10+/-0.19 vs 8.08+/-0.14%; t=-131.325,P=0.000).Conclusion:The therapy of external application of natrii sulfas can effectively relieve the knee pain and eliminate the knee swelling,moreover,its curative effect is better than that of ice compress.

参考文献/References:

[1] Canale ST,Besty JH.坎贝尔骨科手术学[M].王岩,译.12版.北京:人民军医出版社,2014:345-417.
[2] 沈陵,罗漫丽.全膝关节置换术后的疼痛护理[J].中医正骨,2014,26(4):76-77.
[3] 王国强.全国中草药汇编[M].3版.北京:人民卫生出版社,2014:787-789.
[4] 张珏,许乐宜,龚立,等.芒硝外敷治疗颅脑外伤术后脑水肿的临床研究[J].国际中医中药杂志,2015,37(9):785-787.
[5] 蒋协远,王大伟.骨科临床疗效评价标准[M]北京:人民卫生出版社,2005:123-124.
[6] 高福强,李子剑,张克,等.初次全膝关节置换术后肢体肿胀的影响因素研究[J].中国矫形外科杂志,2011,19(9):724-727.
[7] Gibbs DM,Green TP,Esler CN.The local infiltration of analgesia following total knee replacement:a review of current literature[J].J Bone Joint Surg Br,2012,94(9):1154-1159.
[8] 赵斌,曾宪辉,丰新建,等.持续被动运动在全膝关节置换术后康复中的应用[J].中医正骨,2014,26(9):19-20.
[9] 谢琪,左丹,黄华扬,等.持续脉冲加压冷疗对全膝关节置换术后早期功能障碍的影响[J].中国骨科临床与基础研究杂志,2012,4(2):129-132.
[10] Kang JI,Kim YN,Choi H.Effects of Low-intensity Pulsed Ultrasound and Cryotherapy on Recovery of Joint Function and C-reactiveProtein Levels in Patients after Total Knee Replacement Surgery[J].J Phys Ther Sci,2014,26(7):1033-1036.
[11] Adie S,Naylor JM,Harris IA.Cryotherapy after total knee arthroplasty a systematic review and meta-analysis of randomized controlled trials[J].J Arthroplasty,2010,25(5):709-715.
[12] 徐晓华.李晓峰,熊远飞.全膝关节置换后循环加压冷疗系统与间断高渗盐水冰敷应用[J].中国组织工程研究,2013,17(48):8325-8330.
[13] Munk S,Jensen NJ,Andersen I,et al.Effect of compression therapy on knee swelling and pain after total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2013,21(2):388-392.
[14] 魏荣锐,曹姗,杨亚蕾,等.外用芒硝对大鼠外伤性血瘀模型的影响[J].中华中医药杂志,2011,26(8):1719-1722.
[15] 柏亚妹,张曦,吴兴彪.芒硝冰袋冷敷减轻创伤肿痛的研究[J].中华护理杂志,2006,41(9):773-776.
[16] 陈小丽,洪艺,叶卿,等.生栀子粉联合芒硝外敷在创伤性软组织肿痛中的应用[J].中华现代护理杂志,2014,20(34):4395-4397.

相似文献/References:

[1]邢金明.切开复位锁定钢板内固定术和人工半肩关节置换术 治疗老年肱骨近端复杂骨折的对比研究[J].中医正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(10):11.
[2]赵云昌.人工股骨头置换治疗老年粉碎性股骨转子间骨折[J].中医正骨,2015,27(08):31.
[3]张明强.生物型加长柄半髋关节置换术治疗 高龄不稳定股骨转子间骨折疗效观察[J].中医正骨,2015,27(02):56.
[4]蔡云仙.围手术期耳穴按压联合平衡针疗法 在全膝关节置换术后镇痛中的应用[J].中医正骨,2015,27(06):41.
[5]喻长纯,杨明路,王战朝.不同手术方式治疗胫骨平台骨折畸形愈合的体会[J].中医正骨,2015,27(03):37.
[6]魏瑄,宋树春,王金良.术前精确测量和评估在全髋关节置换治疗 成人发育性髋关节发育不良继发骨关节炎中的价值[J].中医正骨,2015,27(01):30.
[7]鲍荣华,陈晓东,王国平,等.Wagner Cone生物型假体置换结合经股骨转子下横形截骨 治疗CroweⅣ型成人发育性髋关节发育不良[J].中医正骨,2015,27(01):33.
[8]喻长纯,杨明路,王战朝.同期髌骨脱位矫正术联合全膝关节置换术治疗 晚期膝骨关节炎合并习惯性髌骨脱位[J].中医正骨,2015,27(01):41.
[9]武理国,沈军,傅国海,等.人工肱骨头置换治疗老年肱骨近端复杂骨折[J].中医正骨,2013,25(10):70.
[10]李国梁,韩广普,闫国强,等.红花化瘀汤薰蒸联合理筋手法 在膝骨关节炎全膝关节置换术后康复中的应用[J].中医正骨,2013,25(12):31.
　Li Guoliang*,Han Guangpu,Yan Guoqiang,et al.Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(10):31.
[11]樊庆阳,任凯晶.定制3D打印切模辅助全膝关节置换术治疗 膝骨关节炎合并股骨干骨折畸形愈合[J].中医正骨,2015,27(11):37.
[12]李翰林,童培建.利福平联合用药配合保留假体清创治疗 人工关节置换术后早期感染及低毒性感染[J].中医正骨,2015,27(09):56.
[13]刘晓雅,孙永强,刘国杰.主动快速康复锻炼对全膝关节置换术后关节活动度的影响[J].中医正骨,2015,27(09):73.
[14]张维平,康两期,陈卫,等.全髋关节置换术围手术期隐性失血的研究进展[J].中医正骨,2015,27(08):61.
[15]宋兵华,孙俊英,倪增良,等.全膝关节置换术前CT测量股骨后髁角的临床意义[J].中医正骨,2015,27(07):38.
[16]王金良,孙京涛,李玲,等.骨水泥联合螺钉修复全膝关节置换术中 胫骨平台内侧骨缺损[J].中医正骨,2015,27(12):55.
[17]徐伟锋,叶健,吴连国.强骨饮对骨质疏松性股骨颈骨折患者全髋关节置换术后 血清骨代谢生化指标和骨密度的影响[J].中医正骨,2015,27(02):12.
　XU Weifeng,YE Jian,WU Lianguo.Effect of Qianggu Yin(强骨饮,QGY)on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(10):12.
[18]张荣,王健.人工全膝关节置换术的围手术期心理护理[J].中医正骨,2015,27(05):77.
[19]齐志远,陈秀民,王在斌,等.桃红四物加黄芪汤预防人工髋膝关节置换术后 下肢深静脉血栓形成[J].中医正骨,2015,27(03):71.
[20]陆吴超,季卫锋,马镇川.关节镜下清创后持续灌洗联合中药口服治疗 全膝关节置换术后急性期感染[J].中医正骨,2015,27(01):51.

备注/Memo

备注/Memo:

通讯作者:季卫峰 E-mail:jiweifeng1230@163.com
更新日期/Last Update: 2016-10-20