冷療、耳穴聯(lián)合多模式鎮(zhèn)痛對全膝關(guān)節(jié)置換術(shù)后康復(fù)效果的臨床研究

劉蔚楠　戴燕鈴　林翔　王榮茂　陳相帆　董洪偉

【摘要】 目的：比較結(jié)合冷療和耳穴的多模式鎮(zhèn)痛對全膝關(guān)節(jié)置換術(shù)（TKA）后康復(fù)的療效。方法：經(jīng)倫理委員會批準(zhǔn)，樣本量估算，以筆者所在醫(yī)院收治的20例膝骨關(guān)節(jié)炎患者作為研究對象，將其隨機(jī)分為試驗組和對照組各10例，比較術(shù)后6 h、24 h、48 h、7 d、14 d疼痛程度（VAS評分）和關(guān)節(jié)活動度，以及隱性失血量。結(jié)果：兩組術(shù)后6、24 h的VAS評分比較差異無統(tǒng)計學(xué)意義（P>0.05）;試驗組術(shù)后48 h、7 d、14 d的VAS評分均低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。兩組術(shù)后6、24、48 h關(guān)節(jié)活動度比較差異無統(tǒng)計學(xué)意義（P>0.05）;試驗組在術(shù)后7、14 d關(guān)節(jié)活動度均高于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。試驗組患者隱性失血量低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：結(jié)合冷療、耳穴的多模式鎮(zhèn)痛，能顯著減少術(shù)后隱性失血量，減少術(shù)后關(guān)節(jié)腫脹、疼痛，改善術(shù)后ROM，操作簡易，具有很高的臨床應(yīng)用價值。

【關(guān)鍵詞】 耳穴; 冷療; 多模式鎮(zhèn)痛; 全膝關(guān)節(jié)置換; 術(shù)后康復(fù)

doi：10.14033/j.cnki.cfmr.2019.19.001 文獻(xiàn)標(biāo)識碼 A 文章編號 1674-6805（2019）19-000-03

Effect of Cold Therapy and Auricular Acupoints Combined with Multimodal Analgesia on Rehabilitation after Total Knee Arthroplasty/LIU Weinan，DAI Yanling，LIN Xiang，et al.//Chinese and Foreign Medical Research，2019，17（19）：-3

【Abstract】 Objective：To compare the effects of multimodal analgesia combined with cold therapy and auricular acupoints on rehabilitation after total knee arthroplasty.Method：According to the ethics committee approval and sample size estimation，20 patients with knee osteoarthritis admitted to our hospital were randomly divided into the experimental group and the control group，10 cases in each group.The pain level（VAS score），joint mobility，the hidden blood loss were compared at 6 h，24 h，48 h，7 d，14 d after surgery were compared.Result：There were no significant differences in VAS score between the two groups at 6 h，24 h after operation（P>0.05），but the VAS score at 48 h，7 d and 14 d after operation in the experimental group were significantly lower than those in the control group（P<0.05）.There were no significant differences in joint motion between the two groups at 6 h，24 h and 48 h after operation（P>0.05）.The range of motion of the experimental group higher than those of the control group at 7 d and 14 d after operation，and the differences were statistically significant（P<0.05）.The hidden blood loss in the experimental group was lower than that in the control group，and the difference was statistically significant（P<0.05）.Conclusion：Multimodal analgesia combined with cold therapy and auricular acupoints，can significantly reduce the hidden blood loss，joint swelling and pain，improve ROM.It is easy to operate and has high clinical value.

【Key words】 Auricular acupoints; Cold therapy; Multimodal analgesia; Total knee arthroplasty; Rehabilitation

First-authors address：The Affiliated Peoples Hospital of Fujian University of Traditional Chinese Medicine，F(xiàn)uzhou 350004，China