循环加压冷疗系统改善全膝关节置换术后症状效果的系统评价

Effects of Cyclic Cryotherapy system on the improvement after total knee arthroplasty:a systematic review

目的系统评价循环加压冷疗系统对全膝关节置换术后早期症状的改善效果。方法计算机检索Cochrane Library、JBI、PubMed、Web of Science、EBSCO、CNKI、万方数据库、中国生物医学文献数据库自建库至2018年5月31日公开发表的在全膝关节置换术后应用循环加压冷疗系统干预的随机对照试验(RCT)文献。由2名研究者按照纳排标准进行文献筛选并提取资料,并用RevMan 5.3.3软件进行统计分析。结果共纳入12篇RCT(976例患者)。Meta分析显示循环加压冷疗系统与冰袋冰敷相比:术后24 h内的疼痛差异有统计学意义[MD=-0.70,95%CI(-0.97,-0.43),P<0.00001];术后48 h内引流量差异有统计学意义[MD=-143.04,95%CI(-166.51,-119.57),P<0.00001];术后1周肿胀消退情况差异有统计学意义[MD=-0.22,95%CI(-0.32,-0.13),P<0.00001]。结论现有证据显示,与冰袋冰敷相比,循环加压冷疗系统具有术后早期止痛、止血,后期消肿,促进恢复,提高舒适度,无冷疗不良反应的优越性。

Objective To evaluate the clinical effects of Cyclic Cryotherapy system on early symptoms after total knee arthroplasty(TKA).Methods The randomized controlled trial(RCT)articles on Cyclic Cryotherapy system after TKA were retrieved from Cochrane Library,JBI,PubMed,Web of Science,EBSCO,CNKI,Wanfang database and China Biology Medicine disc(CBMdisca),with the time limitation from the establishment of the database to 31st May 2018.Two researchers screened the literature according to the criteria of inclusion and exclusion,extracted the data,and used RevMan 5.3.3 software for statistical analysis.Results A total of 12 studies(976 cases)were included.The results of Meta analysis showed that,comparing between the Cyclic Cryotherapy and ice pack,the differences on pain score 24 hours after operation[MD=-0.70,95%CI(-0.97,-0.43),P<0.00001],volume of drainage 48 hours after operation[MD=-143.04,95%CI(-166.51,-119.57),P<0.00001]and swelling 1 week after operation[MD=-0.22,95%CI(-0.32,-0.13),P<0.00001]were all statistically significant.Conclusions The existing evidence shows that compared with the ice pack,the Cyclic Cryotherapy system has the advantages of early postoperative analgesia,hemostasis,later detumescence,promoting recovery,improving comfort and no adverse reactions of cryotherapy.