持续脉冲加压冷疗对全膝关节置换术后早期功能障碍的影响

目的观察持续脉冲加压冷疗对全膝关节置换术（TKA）后患者早期功能障碍的影响。方法采用随机、双盲法将2010年8月至2011年6月在广州军区广州总医院因膝关节骨性关节炎行TKA治疗的40例患者分为常规组与加压组,每组各20例。常规组采用生理盐水冰袋;加压组采用持续脉冲加压冷疗。评估患者术后早期膝关节肿胀程度、引流量、关节活动度及HSS评分等指标。结果加压组患者术后72h膝关节肿胀值和术后48h引流量较常规组减少（P〈0.05）;术后72h、2周主动关节活动度较常规组增加（P〈0.05）;术后2周HSS评分较常规组提高（P〈0.05）。结论持续脉冲加压冷疗有助于TKA术后患者早期消肿、减少引流量、增加关节活动范围、提高耐受性,可促进膝关节功能的整体康复。

The effect of continuous pulse cold compression therapy on early postoperative dysfunction for total knee arthroplasty

Objective To evaluate the effect of continuous pulse cold compression therapy on early postoperative dysfunction for total knee arthroplasty (TKA). Methods From August 2010 to June 2011, a randomized double-blind study was performed at Guangzhou General Hospital of Guangzhou Military Command. Forty patients with knee osteoarthritis undergone TKA were divided into continuous pulse cold compression group (compression group) and traditional ice bag group (control group) postoperatively with 20 patients in each group. The degree of swelling, amount of blood drainage, range of motion of knee joint and HSS scores in two groups were recorded in early postoperative period. Results Compared with those in control group, the degrees of swelling in compression group were lower than at 72 h after surgey (P <0.05); the amount of blood drainage in group decreased at 48 h after surgery (P <0.05); the ranges of motion of knee joint were higher at 72 h and 2 weeks after surgery; HSS scores increased at 2 weeks after surgery (P <0.05). Conclusion Continuous pulse cold compression therapy can relieve swelling degree, reduce the amount of blood drainage, improve ranges of motion of knee joint and enhance the ability of tolerance in early phase after TKA operation.