冷療、耳穴聯合多模式鎮痛對全膝關節置換術后康復效果的臨床研究

劉蔚楠　戴燕鈴　林翔　王榮茂　陳相帆　董洪偉

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

【關鍵詞】 耳穴; 冷療; 多模式鎮痛; 全膝關節置換; 術后康復

doi：10.14033/j.cnki.cfmr.2019.19.001 文獻標識碼 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，Fuzhou 350004，China