局部超声透入利多卡因治疗对全膝关节置换术后患者镇痛效果的影响

目的：观察超声药物透入利多卡因对全膝关节置换术（ TKA ）后患者疼痛的影响。方法采用随机数字表法将112例TKA患者分为观察组及对照组，每组各56例。观察组患者局部超声透入利多卡因治疗，对照组给予超声透入安慰剂治疗。采用NRS评估量表对两组患者静息状态及功能锻炼后局部疼痛情况进行评价，比较两组患者膝关节活动度，并评估治疗安全性。结果观察组患者术后48，72，96 h静息状态下NRS得分分别为（3．96±0．53），（3．25±0．51），（2．62±0．38）分，均优于对照组的（5．25±0．48），（4．32±0．41），（3．43±0．31）分，两组比较差异有统计学意义（t值分别为120．758，98．763，89．224；P＜0．05）。48，72，96 h功能锻炼后，观察组NRS得分为（4．90±0．59），（4．17±0．72），（3．28±0．36），明显优于对照组（5．965±0．58），（4．97±0．62），（3．86±0．36）分，两组比较差异有统计学意义（t值分别为88．152，86．375，79．249；P＜0．05）；观察组患者术后2，3，7 d膝关节活动度分别为（45．8±7．6）°，（63．2±8．7）°，（95．6±8．2）°，明显优于对照组的（41．1±6．9）°，（55．3±5．8）°，（88．9±6．3）°，两组比较差异有统计学意义（ t值分别为78．024，87．018，89．472；P＜0．05），治疗期间未出现不良反应，安全纪录均为Ⅰ级。结论超声药物透入可有效缓解TKA后疼痛，改善膝关节活动度。

Effect of local lidocaine drug phonophoresis on analgesic in patients undergoing total knee arthroplasty

Objective To observe the effect of phonophoresis on analgesic in patient undergoing total knee arthroplasty （ TKA） .Methods One hundred and twelve patients undergoing TKA were randomly divided into the observation group and the control group according to the random number table , each with 56 cases.The observation group received the lidocaine drug phonophoresis , and the control group received the placebo drug phonophoresis .The level of local pain was evaluated by numerical rating scale （ NRS） in the resting state and after the functional exercise in two groups .The activity of knee joint and the security of treatment were also evaluated.Results The scores of NRS in the observation group were respectively （3.96 ±0.53）, （3.25 ±＆nbsp;0.51）, （2.62 ±0.38） in the resting state 48 h, 72 h, 96 h after operation, and were better than （5.25 ± 0.48）, （4.32 ±0.41）, （3.43 ±0.31） in the control group, and the differences were statistically significant （t=120.758, 98.763, 89.224, respectively; P〈0.05）.The scores of NRS in the observation group were respectively （4.90 ±0.59）, （4.17 ±0.72）, （3.28 ±0.36） 48 h, 72 h, 96 h after functional exercise, and were better than （5.965 ±0.58）, （4.97 ±0.62）, （3.86 ±0.36） in the control group, and the differences were statistically significant （t=88.152, 86.375, 79.249, respectively; P〈0.05）.The activities of knee joint were respectively （45.8 ±7.6）°, （63.2 ±8.7）°, （95.6 ±8.2）°in the observation group, and better than （41.1 ±6.9）°, （55.3 ±5.8）°, （ 88.9 ±6.3）°in the control group, and the differences were statistically significant （t=78.024, 87.018, 89.472, respectively; P〈0.05）.No obvious adverse reaction was found during the treatment , and the records of safety were all grade I .Conclusions Phonophoresis can effectively alleviate the pain after TKA , and improve the activity of knee joint .