短时冷冻结合镇痛药物与单纯镇痛药物对全膝关节置换术后疼痛缓解的疗效分析(1)
摘 要：目的 验证30 min短时冷冻治疗结合镇痛药物治疗对全膝关节置换术后疼痛缓解效果是否优于单独使用镇痛药物。方法 选取2013年8月～2015年8月在重庆医科大学附属第一医院接收52例全膝关节置换术的患者，随机分为两组，每组26例，对照组在疼痛发作期仅给予镇痛药治疗；观察组在疼痛发作期采用镇痛药联合冷冻治疗，记录患者疼痛评分及疼痛管理满意度评分。结果 两种治疗方法在患者疼痛评分变化和疼痛管理满意度，差异无统计学意义(P >0.05)。与在第一个疼痛发作期采用镇痛药物联合冷冻治疗患者的疼痛管理满意度相比，在第二个疼痛发作期采用镇痛药物联合冷冻治疗的患者疼痛管理满意度较高，差异有统计学意义(P<0.05)。结论 止痛药物结合短时冷冻治疗相比于单纯给予止痛药物没有显著减少疼痛感或提高患者的疼痛管理满意度。
关键词：短时冷冻治疗；镇痛药物；全膝关节置换术
中图分类号：R687.4；R441.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.026
, http://www.100md.com
文章编号：1006-1959(2018)07-0082-04
Effect of Short-term Freezing Combined with Analgesic Drugs and Analgesic Drugs on Pain Relief after Total Nnee Arthroplasty
CAI li，TANG Yong-li
(Department of Orthopaedics，First Affiliated Hospital of Chongqing Medical University，Chongqing 400016，China)
Abstract：Objective To investigate whether the effect of 30 min short term cryotherapy combined with analgesic drugs on pain relief after total knee arthroplasty is better than that of analgesic drugs alone.Methods From August 2013 to August 2015，52 patients received total knee arthroplasty in the first affiliated Hospital of Chongqing Medical University were randomly divided into two groups： 26 cases in each group.The control group was treated with analgesics only in the period of pain attack.The patients in the observation group were treated with analgesics combined with cryotherapy during the period of pain attack.The patients' pain score and pain management satisfaction were recorded.Results There was no significant difference in pain score and pain management satisfaction between the two treatments(P>0.05).Compared with the pain management satisfaction of patients who received analgesic drugs combined with cryotherapy in the first episode of pain attack，pain management satisfaction was higher in second pain attack patients who received analgesic drugs combined with cryotherapy，and the difference was statistically significant(P<0.05).Conclusion The combination of analgesic drugs and short-term cryotherapy has no significant effect on reducing pain or improving the patients' satisfaction with pain management compared with the simple administration of analgesic drugs.
, 百拇医药
Key words：Short-term cryotherapy；Analgesic drugs；Total knee arthroplasty
全膝关节置换术后往往需要频繁使用镇痛药物以减轻局部疼痛 [1，2]。但大剂量使用镇痛药物可能会导致患者胃肠道损伤、呼吸抑制、循环衰竭等一系列问题[3-5]。因此，抬高患肢、按摩疗法、香薰疗法等非药物疗法结合镇痛药物治疗，能在减少镇痛药物使用的情况下更好地控制患者术后疼痛[6，7]。冷冻治疗是常见的术后镇痛物理治疗方式[8]，目前，术后24～72 h长时程连续冷冻治疗，由于成本及设备要求等原因尚未被大多數临床机构所采用[9-11]。近期研究显示，在骨科手术部位采用短时冷冻治疗能显著降低患者疼痛水平[10，12-14]。本次研究是确定30 min冷冻治疗结合止痛药物的治疗方式是否为全膝关节置换术(TKA)提供了比无冷冻常规治疗更好的术后镇痛效果，现报道如下。, http://www.100md.com(蔡莉 唐永利)
关键词：短时冷冻治疗；镇痛药物；全膝关节置换术
中图分类号：R687.4；R441.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.026
, http://www.100md.com
文章编号：1006-1959(2018)07-0082-04
Effect of Short-term Freezing Combined with Analgesic Drugs and Analgesic Drugs on Pain Relief after Total Nnee Arthroplasty
CAI li，TANG Yong-li
(Department of Orthopaedics，First Affiliated Hospital of Chongqing Medical University，Chongqing 400016，China)
Abstract：Objective To investigate whether the effect of 30 min short term cryotherapy combined with analgesic drugs on pain relief after total knee arthroplasty is better than that of analgesic drugs alone.Methods From August 2013 to August 2015，52 patients received total knee arthroplasty in the first affiliated Hospital of Chongqing Medical University were randomly divided into two groups： 26 cases in each group.The control group was treated with analgesics only in the period of pain attack.The patients in the observation group were treated with analgesics combined with cryotherapy during the period of pain attack.The patients' pain score and pain management satisfaction were recorded.Results There was no significant difference in pain score and pain management satisfaction between the two treatments(P>0.05).Compared with the pain management satisfaction of patients who received analgesic drugs combined with cryotherapy in the first episode of pain attack，pain management satisfaction was higher in second pain attack patients who received analgesic drugs combined with cryotherapy，and the difference was statistically significant(P<0.05).Conclusion The combination of analgesic drugs and short-term cryotherapy has no significant effect on reducing pain or improving the patients' satisfaction with pain management compared with the simple administration of analgesic drugs.
, 百拇医药
Key words：Short-term cryotherapy；Analgesic drugs；Total knee arthroplasty
全膝关节置换术后往往需要频繁使用镇痛药物以减轻局部疼痛 [1，2]。但大剂量使用镇痛药物可能会导致患者胃肠道损伤、呼吸抑制、循环衰竭等一系列问题[3-5]。因此，抬高患肢、按摩疗法、香薰疗法等非药物疗法结合镇痛药物治疗，能在减少镇痛药物使用的情况下更好地控制患者术后疼痛[6，7]。冷冻治疗是常见的术后镇痛物理治疗方式[8]，目前，术后24～72 h长时程连续冷冻治疗，由于成本及设备要求等原因尚未被大多數临床机构所采用[9-11]。近期研究显示，在骨科手术部位采用短时冷冻治疗能显著降低患者疼痛水平[10，12-14]。本次研究是确定30 min冷冻治疗结合止痛药物的治疗方式是否为全膝关节置换术(TKA)提供了比无冷冻常规治疗更好的术后镇痛效果，现报道如下。, http://www.100md.com(蔡莉 唐永利)