膝关节镜下前交叉韧带重建术后冰敷对患者早期康复效果的影响

目的探讨膝关节镜下前交叉韧带重建术后局部冰敷疗法的早期临床效果。 方法前瞻性收集2016年1月至2016年6月第二军医大学长征医院关节外科行膝关节镜下前交叉韧带重建术的患者共40例，其中男性33例，女性7例，采用随机数字表法随机分为两组，每组20例。冰敷组平均年龄（27±8）岁，对照组（27±7）岁。对照组术后给予常规护理，冰敷组在常规护理的基础上术后立即给予10% NaCl冰袋冰敷，观察两组患者疼痛度，肿胀度，膝关节活动度，足趾氧饱和度的区别。 结果所有患者均获得满意随访，随访率100%。随访时间6个月，冰敷组患者术后6 h、12 h、24 h、48 h、72 h疼痛视觉模拟评分（VAS）均小于对照组，差异有统计学意义（t=4.160，P<0.05；t=5.286，P<0.05；t=6.799，P<0.05；t=14.150，P<0.05；t=5.670，P<0.05）。冰敷组患膝取三定点测量术后24、48、72 h肿胀值均小于对照组，且差异具有统计学意义（髌骨中点t=4.101，P<0.05；t=9.430，P<0.05；t=5.800，P<0.05；髌骨上极2 cm处t=3.187，P=0.003；t=6.539，P<0.05；t=3.002，P<0.05；腓肠肌最粗处t=4.105，P<0.05; t=8.437，P<0.05；t=5.670，P<0.05）。冰敷组术后6 w膝关节活动度优于对照组，差异具有统计学意义（t=7.503，P<0.05）。冰敷组术后6个月膝关节活动度优于对照组，差异无统计学意义（t=1.872，P=0.067）。冰敷组与对照组患肢足趾末梢氧饱和度差异无统计学意义。 结论膝关节镜下前交叉韧带重建术后立即给予冰袋冰敷并持续72 h，并结合适当的功能锻炼，可减轻术后早期疼痛、减轻患肢肿胀发生、改善患肢膝关节活动度，同时冰敷并不会影响患肢末梢血运。

Effection of ice pack for the early rehabilitation of the patient underwent anterior cruciate ligament reconstruction with arthroscopy

ObjectiveTo investigate the early clinical effect of local ice therapy after anterior cruciate ligament reconstruction with knee arthroscopy. MethodsA total of 40 patients underwent reconstruction of anterior cruciate ligament with knee arthroscopy in our department between January 2016 and June 2016.They were divided into two groups by random number table, and there were 20 cases in each group. The control group received routine nursing after the operation, and the observation group was give nice compress with cold packs besides routine nursing at the same time. The difference of pain degree, swelling degree, knee mobility and toe oxygen saturation between the two groups were observed. ResultsThe VAS of the patients in the observation group after 6, 12, 24, 48 and 72 hours were all smaller than that of the control group, the difference was statistically significant. The swelling value of observation group after 24, 48 and 72 hours was smaller than that of control group, and the difference was statistically significant. The knee mobility of the observation group was better than that of the control group at 6 weeks after operation, and the difference was statistically significant. The knee mobility of the observation group was better than that of the control group at 6 months after operation, and the difference was not statistically significant. There was no significant difference in toe oxygen saturation between the two groups. ConclusionPatients after anterior cruciate ligament reconstruction with knee arthroscopy, given ice compress and lasted for 72 hours, and combined with the appropriate function exercise, can help to reduce postoperative pain and limb swelling, improve knee joint motion effectively, and the ice compress will not affect the patient's peripheral blood supply.