针刺法用于人工全膝关节置换术术后镇痛的研究进展

Research progress of acupuncture applied in the postoperative analgesia of total knee arthroplasty

人工全膝关节置换术(TKA)近年来已经广泛应用于骨科骨折患者中,TKA手术治疗的目的是解除膝关节疼痛以及膝关节功能的重建,但部分患者术后仍存在异常疼痛现象。以往对于TKA镇痛多采取多模式镇痛,如静脉镇痛、硬膜外镇痛、连续外周股神经阻滞,但均各具有一定的缺点。近年来临床研究发现,针刺镇痛在国内及国际上治疗TKA术后疼痛正逐渐得到广泛重视与认可,并取得了较好的效果。针刺及其相关技术作为临床手术镇痛的一种辅助治疗手段,在缓解患者术后疼痛中发挥了重要作用。本文从TKA术后疼痛发生的原因、TKA围术期常用的传统镇痛方法及针刺镇痛的作用机制、针刺镇痛用于TKA术后的镇痛效果方面进行总结分析,旨在为临床开展新的镇痛方案提供参考依据。

In recent years, the total knee arthroplasty （TKA） has been widely used in patients with fracture in the De- partment of Orthopedics, the purpose of TKA is relieving pain of knee joint and reconstruction of knee joint function, but some patients still have abnormal pain after operation. In the past, multimodal analgesia, such as intravenous anal- gesia, epidural analgesia and continuous peripheral nerve block, is used for TAK analgesia, but all of them have certain disadvantages. In recent years, clinical studies have found that acupuncture analgesia in the treatment of postoperative pain of TKA in both domestic and international is gradually getting wide attention and recognition, and it has achieved good effects. As an adjuvant therapy of clinical surgery analgesia, acupuncture and related technologies play an impor- tant role in relieving the postoperative pain of patients. This paper summarizes the cause of postoperative pain of TKA, common traditional analgesic methods during perioperative TKA and its mechanism of acupuncture analgesia, the anal- gesic effect of acupuncture analgesia for postoperative TKA, aimed at providing reference for performing a new anal- gesic program in clinic.