摘要
目的研究人工全膝关节置换术后局部在超声引导下应用依托芬那酯凝胶镇痛的疗效和对关节功能恢复的影响。方法将术前确诊为膝关节骨性关节炎、行单侧人工膝关节置换术的80例患者随机平均分为实验组和对照组,2组患者给予相同的基础镇痛方案,从术后1 d起实验组应用超声在患膝透入依托芬那酯凝胶(2次/d)至术后7 d,随访2组患者至术后8周。由未参与患者分组及研究操作的疼痛管理小组成员对患者术后疼痛评分、康复运动情况进行观察,分别记录术前及术后1 d、3 d、5 d、7 d的静止和运动疼痛视觉模拟评分(VAS),术前及术后3 d、5 d、7 d、8周的膝关节活动度,术前及术后8周末次随访的美国特种外科医院(HSS)膝关节功能评分,并进行统计学分析。结果 76例(实验组37例,对照组39例)患者最后完成随访。术后3 d、5 d、7 d实验组患者静止和运动疼痛VAS评分低于对照组,有统计学差异(P<0.05)。术前2组比较,膝关节活动度、HSS膝关节功能评分均无统计学差异(P>0.05)。术后3 d、5 d、7 d、8周时实验组膝关节活动度明显优于对照组,术后8周实验组HSS膝关节功能评分明显优于对照组,差异均有统计学意义(P<0.05)。结论超声透入依托芬那酯凝胶能够有效缓解人工全膝关节置换术术后疼痛,有助于膝关节术后功能康复,是人工全膝关节置换术术后镇痛的优良方法。
Objective To evaluate the efficacy of phonophoresis of etofenamate gel for postoperative analgesia after total knee arthroplasty （TKA）. Methods A total of 80 adult patients were randomly divided into experimental and control groups （n = 40 in each group）. The same basic analgesia protocol was performed in both groups ,while phonophoresis of etofenamate gel was performed only in the experimental group （twice per day, from day 1 to day 7, postoperatively）. Data recorded during an g-week follow-up included Visual Analogue Scale （VAS） scores at rest and during continuous passive motion before surgery and 1 d, 3 d, ~ d,and 7 d after surgery, range of motion before surgery and 3 d, 5 d, 7 d, and 8 weeks after surgery, and Hospital for Special Surgery （ass） scores before surgery and 8 weeks after surgery. SPSS 18.0 was used for statistical analysis. Results The VAS scores at rest and during continuous passive motion 3 d, 5 d, and 7 d after surgmy were lower in the experimental group than in the control group （P 〈 0.05）. The range of motion 3 d, 5 d, 7 d, and 8 weeks after surgery was better in the experimental group than in the control group （P 〈 0.05）. The HSS scores 8 weeks after surgery were better in the experimental group than in the control group （P 〈 0.05）. Conclusion Phonophoresis of etofenalnate gel provides effective pain con- trol after TKA and is helpful for early functional recovery.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2017年第11期1028-1031,共4页
Journal of China Medical University
