[1]张禄锴,马剑雄,匡明杰,等.全膝关节置换术中膝关节周围注射药物镇痛的有效性和安全性Meta分析[J].中医正骨,2017,29(08):42-47.
　ZHANG Lukai,MA Jianxiong,KUANG Mingjie,et al.Clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(08):42-47.
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全膝关节置换术中膝关节周围注射药物镇痛的有效性和安全性Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年08期
页码:
42-47
栏目:
文献研究
出版日期:
2017-08-20

文章信息/Info

Title:
Clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty:a meta analysis
作者:
张禄锴; 马剑雄; 匡明杰; 赵杰; 马信龙
天津市天津医院,天津 300211
Author(s):
ZHANG Lukai; MA Jianxiong; KUANG Mingjie; ZHAO Jie; MA Xinlong
Tianjin Hospital,Tianjin 300211,China
关键词:
关键词 关节成形术; 置换; 膝;  Meta分析;  系统评价;  麻醉; 局部
Keywords:
Key words arthroplasty; replacement; knee;  Meta-analysis;  systematic review;  anesthesia; infiltration
摘要:
目的:系统评价全膝关节置换术(total knee arthroplasty,TKA)中膝关节周围注射药物镇痛的有效性和安全性。方法:应用计算机检索Cochrane Library、PubMed、Embase、CNKI、CBM、WanFang Data、VIP建库至2017年3月29日国内外公开发表的所有TKA术中膝关节周围注射药物(注射组)与未注射药物(未注射组)镇痛的随机对照研究文献。由2位研究人员独立对检索到的文献进行筛选与质量评价,采用Revman5.3软件进行Meta分析。结果:共检索出281篇文献,经逐层筛选最终纳入10篇文献,中文文献5篇、英文文献5篇。共涉及700例患者,注射组349例、未注射组351例。Meta分析结果显示,注射组术后制动状态疼痛视觉模拟评分和运动状态疼痛视觉模拟评分均低于未注射组[WMD=-0.78,95%CI(-1.06,-0.50); WMD=-1.36,95%CI(-1.66,-1.07)]; 注射组术后3 d时的膝关节活动度大于未注射组[WMD=5.84,95%CI(0.47,11.21)]; 注射组患者术后达到屈膝90°和伸直膝关节所用时间均比未注射组少[WMD=-2.92,95%CI(-4.96,-0.88); WMD=-19.77,95%CI(-24.89,-14.64)]; 注射组术后恶心、呕吐的发生率低于未注射组[RR=0.56,95%CI(0.35,0.87)]; 2组术后深静脉血栓发生率和切口感染发生率比较,组间差异均无统计学意义[RR=0.89,95%CI(0.37,2.16); RR=1.00,95%CI(0.38,2.61)]。结论:TKA术中膝关节周围注射镇痛药物能有效缓解疼痛、促进膝关节功能恢复,而且安全性较高。
Abstract:
ABSTRACT Objective:To systematically review the clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty(TKA).Methods:All the randomized controlled trial(RCT)articles about analgesia with peri-knee drug injection(injection group)and without peri-knee drug injection(non-injection group)in TKA that published at home and abroad included from database establishing to March 29,2017 were retrieved from Cochrane Library,Pubmed,Embase,China national knowledge internet,CBM,WanFang Database and VIP Database through computer.The acquired articles were screened and the quality of research in the articles was evaluated independently by two researchers,and a Meta-analysis was conducted by using Revman 5.3 software.Results:Two hundred and eighty-one articles were searched out.After screening,10 articles(5 Chinese articles and 5 English articles)were included in the final analysis,349 patients in injection group and 351 in non-injection group.The result of Meta-analysis demonstrated that(1)the pain visual analogue scale(VAS)scores in braking condition and motion condition were lower in injection group compared to non-injection group respectively after TKA[WMD=-0.78,95%CI(-1.06,-0.50); WMD=-1.36,95%CI(-1.66,-1.07)];(2)the knee range of motion were greater in injection group compared to non-injection group at 3 days after TKA[WMD=5.84,95%CI(0.47,11.21)];(3)the time spent in bending knee to a angle of 90 degrees and in straightening knee were less in injection group compared to non-injection group after TKA[WMD=-2.92,95%CI(-4.96,-0.88); WMD=-19.77,95%CI(-24.89,-14.64)];(4)the incidences of nausea and vomiting were lower in injection group compared to non-injection group after TKA[RR=0.56,95%CI(0.35,0.87)]; and(5)there was no statistical difference in the incidences of deep venous thrombosis and incisional wound infection between the 2 groups after TKA[RR=0.89,95%CI(0.37,2.16); RR=1.00,95%CI(0.38,2.61)].Conclusion:Analgesia by peri-knee drug injection can effectively alleviate knee pain and promote knee functional recovery after TKA,meanwhile it has high safty.

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备注/Memo

备注/Memo:
通讯作者:马信龙 E-mail:ZLMM10@163.com 第一作者为天津中医药大学2016级硕士研究生
更新日期/Last Update: 2017-12-29