摘要
目的:探讨收肌管阻滞术(addcutor canal block,ACB)联合经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)在全膝关节置换术(total knee arthroplasty,TKA)术后镇痛及对早期功能锻炼的效果。方法:选取2019年1月至2020年8月初次单侧行TKA的患者84例,其中男45例,女39例;年龄66~77(72.8±8.9)岁;身体质量指数(body mass index,BMI)19~25(23.6±3.5)kg/m^(2)。按照随机数字表法将患者分为收肌管阻滞术联合经皮穴位电刺激组(TEAS+ACB组)和单纯收肌管阻滞术组(ACB组),每组42例。ACB组术中实施ACB,TEAS+ACB组在ACB基础上于术后第1~7天行双下肢TEAS。记录并比较两组术后6,12,24,48,72 h的疼痛视觉模拟评分(visual analogue scale,VAS),术后第1,2,3,7天的膝关节功能,术后第7天膝关节活动度与住院天数。结果:TEAS+ACB组VAS评分在静息、活动状态下术后6,12 h与ACB组相比差异无统计学意义(P>0.05),在术后24,48,72 h均低于ACB组(P<0.05)。TEAS+ACB组膝关节活动度在术后第1天与ACB组相比差异无统计学意义(P>0.05),在术后第2,3,7天均大于ACB组(P<0.05)。TEAS+ACB组住院天数小于ACB组,术后第7天膝关节活动度大于ACB组(P<0.05)。结论:TEAS联合ACB较单纯的ACB有更好的术后镇痛效果,促进患者早期功能锻炼,对TKA术后镇痛是安全、有效的。
Objective:To evaluate the efficacy of adductor canal block(ACB)combined with transcutaneous electrical acupoint stimulation(TEAS)for postoperative analgesia and early functional exercise after total knee arthroplasty(TKA).Methods:A total of 84 patients underwent primary unilateral TKA from January 2019 to August 2020 were selected,including 45 males and 39 females,aged 66-77(72.8±8.9)years;body mass index(BMI)was for 19-25(23.6±3.5)kg/m^(2).They were divided into adductor canal block combined with transcutaneous electrical acupoint stimulation group(TEAS+ACB group)and simple adductor canal block group(ACB group)according to random number table method,42 cases in each group.ACB was performed in ACB group during the operation.And TEAS was performed in TEAS+ACB group on bilateral lower limbs in 1-7 days postoperative on the basis of ACB.VAS scores at 6,12,24,48,72 h after surgery,knee function at 1,2,3,7 days after surgery,knee motion at 7 days after surgery and length of hospitalization days were recorded and compared between the two groups.Results:There were no significant differences in VAS of rest pain and activity pain in postoperative 6,12 h between two groups(P>0.05),but the VAS of TEAS+ACB group was lower at 24,48,72 h after surgery(P<0.05).There was no significant difference in at 1 day postoperatively between two groups(P>0.05),but the knee function of TEAS+ACB group was better than that of the ACB group in 2,3,7 days postoperatively(P<0.05).The length of hospitalization days in were less than in ACB group.On the 7th day after operation,the knee motion of TEAS+ACB group was greater than that of the ACB group(P<0.05).Conclusion:TEAS combined with ACB has a better postoperative analgesic efficacy than simple ACB,and can promote early functional exercise of patients.It is safe and effective for postoperative analgesia after TKA.
作者
葛梅
翟晓军
李勇
GE Mei;ZHAI Xiao-jun;LI Yong(Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine,Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine,Hangzhou 311200,Zhejiang,China)
出处
《中国骨伤》
CAS
CSCD
2021年第8期750-754,共5页
China Journal of Orthopaedics and Traumatology
基金
杭州市卫生科技计划项目(编号:B20200155)。
关键词
全膝关节置换术
收肌管阻滞术
经皮穴位电刺激
镇痛
Total knee arthroplasty
Adductor canal block
Transcutaneous electrical acupoint stimulation
Analgesia
