肩关节镜术后患者加压冷疗的效果观察

Effects of postoperative compression cryotherapy on patients with shoulder joint arthroscopy

目的探讨肩关节镜术后患者加压冷疗的效果。方法于2012年9月至2014年2月将40例肩关节镜术后患者,随机分为实验组和对照组各20例。实验组术后开始冷疗,每8h 1次,每次30min,连续48h;对照组术后给予常规护理。分别在术前及术后24h、48h,采用视觉模拟评分法(visual analogue scale score,VAS)评估疼痛,用3个固定位置点(即以外上髁为起点15cm处、20cm处的上臂围周径、腋窝周径)的肿胀值评估肿胀。结果实验组术后24h、48h VAS评分平均为(2.9±1.2)分、(2.1±1.3)分;对照组术后24h、48h VAS评分为(4.2±1.6)分、(3.1±1.1)分。实验组术后VAS评分低于对照组,差异有统计学意义(P<0.05)。实验组术后24h、48h肿胀值为(1.6±0.7)cm、(1.0±0.5)cm;对照组以外上髁为起点15cm处术后24h、48h肿胀值为(2.4±1.1)cm、(1.8±0.8)cm。实验组术后24h、48h肿胀值为(2.1±1.1)cm、(1.3±0.8)cm;对照组以外上髁为起点20cm处术后24h、48h肿胀值为(2.9±1.2)cm、(2.1±1.1)cm。实验组术后24h、48h肿胀值为(2.4±1.2)cm、(1.8±1.0)cm;对照组腋窝周径术后24h、48h肿胀值为(3.3±1.4)cm、(2.7±1.2)cm。实验组术后肿胀值低于对照组,差异有统计学意义(P<0.05),无冻伤病例。结论肩关节镜术后应用加压冷疗装置能够减轻患肢疼痛和肿胀,有利于早期功能锻炼,促进肩关节功能恢复。

Ohjective To explore the effects of postoperative compression cryotherapy on patients underwent shoulder joint arthroscopy. Methods Forty patients underwent shoulder joint arthroscopy were randomly divided into cryotherapy group and control group with 20 patients in each group between September 2012 and February 2014. Patients in eryotherapy group received cryotherapy 30 rains every 8 hours within 48 hours postoperatively. Patients in control group received routine care. Visual analogue scale was used to assess postoperative pain,and perimeters of three parts （15 cm and 20 cm above lateral epicondyle of humerus,and armpit） were measured to assess swelling preoperatively and 24,48 hours after operation. Results The average scores of visual analogue scale in crymotherapy group were 2.9±1.2 and 2.1±1.3. and those in control group were 4.2±1.6,3.1±1.1 for 24,48 hours postoperatively, The pain level of cryotherapy group was statistically significantly lower than that of control group（P〈0.05）. The status of swelling of cryotherapy group was superior to that of control group（P〈0.05） and with no cold injury cases. Conclusion Postoperative compression cryotherapy for patients underwent shoulder joint arthroscopy can alleviate pain and swelling effectively,and it is beneficial to early functional exercise and shoulder joint recovery.