冷敷对急性踝关节扭伤疗效影响的病例对照研究

目的:探讨传统的休息、冷敷、加压与抬高患肢(RICE)干预与仅做休息、加压与抬高患肢(RCE)干预,两种不同干预方法对于治疗急性踝关节扭伤的临床疗效,以明确冷敷治疗的临床中期效益。方法:自2013年1月至2014年3月,收集急性踝关节扭伤患者89例,男30例,女59例;年龄18～60岁,平均36岁;受伤至就诊时间3～24 h,平均9 h.按就诊顺序随机分为2组,RICE干预组44例,RCE干预组45例,RICE组接受休息、冰敷、加压包扎与抬高患肢的干预,RCE组不接受冰敷但其他干预相同。主要疗效指标采用Karlsson评分,次要疗效指标采用疼痛视觉模拟量表、患者满意度视觉模拟量表。安全性观测指标包括不良事件的观察。结果:在损伤2周后,RICE组的Karlsson评分44.66±11.58,与RICE组46.67±8.52相比,差异无统计学意义(P>0.05).治疗后,RICE组与RCE组的Karlsson评分均高于治疗前。两组患者在疼痛、疗效满意方面比较差异均无统计学意义(P>0.05).此外,两组患者均未见不良反应。结论:冷敷治疗并未能获得更大的终点效益,同时也没有证据表明冷敷影响了关节功能的恢复。

Case-control study on cold compress for acute ankle sprain

Objective:To explore rest,cold compress and elevate(RICE) with rest,compress and elevate (RCE)without cold for the treatment of acute ankle sprain,in order to clear mid-term clinical effects. Methods:Eighty-nine patients with acute ankle sprains were collected from January 2013 to March 2014,including 30 males and 59 females aged from 18 to 60 years old with an average of 36 years old; the time from injury to hospital ranged from 3 to 24 h with an average of 9 h. All patients were divided into two groups according to visiting sequence. There were 45 patients in RICE group,and 45 patients in RCE groups. The main therapeutic effect index was evaluated by Karlsson scoring,and secondary therapeutic effect index was pain and satisfactory VAS scores. Safety index evaluated by adverse event. Results:On the 2nd weeks after injury,Karlsson score in RICE group was 44.66±11.58,and 46.67±8.52 in RCE group,while there was no statistical significance between two groups in Karlsson scores(P>0.05). Karlsson score of two groups after treatment were higher than before treatment. There was no significantly meaning in pain and satisfactory VAS scores between two groups (P> 0.05). No adverse reaction were occurred between two groups. Conclusion:Cold compress did not receive much more final gains,and no evidence showed cold compress could affect recovery of joint function.