肩关节镜术后患者不同加压冷疗时间的效果观察被引量：3

Effect of postoperative compression cryotherapy at different durations on patients with shoulder joint arthroscopy

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摘要目的探讨不同加压冷疗时间对肩关节镜术后患者的效果.方法将行肩关节镜手术患者60例按随机数字表法分为3组,即观察1组20例,观察2组20例,观察3组20例.3组患者术后在常规护理的基础上给予不同时间的加压冷疗,观察1组术后每8小时1次,每次30 min,连续24 h;观察2组术后每8小时1次,30 min/次,连续48 h;观察3组术后每8小时1次,每次30 min,连续72 h;3组患者分别在术前及术后24、48、72 h采用视觉模拟量表（VAS）评估疼痛,测量3个固定位置点的周径计算肿胀值评估肿胀（即肱骨外上髁上20、25 cm处的上臂围周径及腋窝周径）.结果观察1组、观察2组、观察3组患者术后24 h VAS评分比较差异无统计学意义（P〉0.05）;术后48 hVAS评分分别为（3.50 ± 1.10）、（2.65 ± 1.50）、（2.05 ± 1.10）分,比较差异有统计学意义（F=6.838,P=0.002）,进一步用LSD进行3组间两两比较,差异均有统计学意义（P〈0.05）;术后72 hVAS评分分别为（3.65 ± 1.23）、（2.65 ± 1.50）、（1.80 ± 1.11）分,比较差异有统计学意义（F=10.366,P=0.000）,进一步用LSD进行3组间两两比较,差异均有统计学意义（P〈0.05）.3组患者术后24 h肱骨外上髁上20、25 cm和腋窝周径肿胀值比较差异无统计学意义（F=1.208、2.097、0.427,均P〉0.05）;术后48 h肱骨外上髁上20、25 cm和腋窝周径肿胀值比较差异有统计学意义（F=15.577、17.128、5.109,P〈0.05）,进一步用LSD进行3组间两两比较,观察1组与观察2组、观察1组与观察3组差异有统计学意义（P〈0.05）,观察2组与观察3组差异无统计学意义（P〉0.05）;术后72 h肱骨外上髁上20、25 cm和腋窝周径肿胀值比较差异有统计学意义（F=24.159、20.963、8.496,P=0.000）,进一步用LSD进行3组间两两比较,差异均有统计学意义（P〈0.05）.结论肩关节镜术后加压冷疗72 h减轻患肢疼痛和肿胀效果最显著,有利于早期功能锻炼,促进肩关节功能恢复. Objective To explore the effects of postoperative compression cryotherapy at different durations on patients underwent shoulder joint arthroscopy. Methods Sixty patients underwent shoulder joint arthroscopy were divided into 3 study groups by random digits table method： group 1 （20 cases）, group 2（20 cases）,group 3（20 cases）.The study populations with routine care were offered compression cryotherapy at different durations：group1 was managed with 30 mins postoperative cryotherapy every 8 h within 24 h, group2 with the same treatment within 48 h, group 3 within 72 h. Visual Analogue Scale （VAS）was used to assess preoperative as well as postoperative pains,and perimeters of three parts（20 cm and 25 cm above lateral epicondyle of humerus,and armpit）were measured to assess swelling at different durations-preoperatively and 24,48,72 h after operation. Results There was no significant difference in the scores of VAS at 24 h after operation among three groups（P〉0.05）.The score of VAS at 48 h after operation in group 1,group 2,group 3 was（3.65±1.23）,（2.65±1.50）,（1.80±1.11）points,and there was significant difference（F=6.838,P=0.002）,a further comparison,there was significant difference between the two groups（P〈0.05）.The score of VAS at 72 h after operation in group 1,group 2,group 3 was（3.50± 1.10）,（2.65±1.50）,（2.05±1.10）points,and there was significant difference（F=10.366,P=0.000）,a further comparison, there was significant difference between the two groups （P〈0.05）. There was no significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus, and armpit at 24 h after operation among three groups（F=1.208, 2.097, 0.427, P〉0.05）. There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 48 h after operation among three groups（F=15.577, 17.128, 5.109, P〈0.05）, a further comparison, there was significant difference between group 1 and group 2, group 1 and group 3（P〈0.05）, but there was no significant difference between group 2 and group 3（P〉0.05）.There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 72 h after operation among three groups（F=24.159, 20.963, 8.496, P〈0.05）, a further comparison, there was significant difference between the two groups （P〈0.05）. Conclusions 72 h postoperative compression cryotherapy for patients underwent shoulder joint arthroscopy can be the most statistically significant factor to alleviate pain and swelling effectively,beneficial to early functional exercise and shoulder joint recovery.