损伤灵软膏联合ERAS对TKA术后肿痛的临床疗效观察

Clinical Effect of Sunshangling Ointment Combined with ERAS on Swelling and Pain after TKA

目的:探讨在全膝关节置换术(TKA)围手术期中采用加速康复外科(ERAS)联合中药自制剂损伤灵软膏的临床疗效。方法:收集骨二科自2019年12月-2021年4月行单侧TKA治疗的患者90例,随机分为A(空白组)、B(对照组)、C(治疗组)3组各30例。A组围手术期常规治疗,B组围术期ERAS治疗,C组在B组基础上术后第1 d外敷损伤灵软膏,记录10 d的结果数据。观察对比3组患者疼痛视觉评分(VAS)、患肢周径平均值(L)、美国特种外科医院膝关节评分(HSS)以及膝关节主动屈伸活动度(ROM)。结果:3组患者在VAS评分及患肢周径的组间比较中,B、C两组在术后3 d、5 d、10 d的结果评分均优于A组(P<0.05),但在术后3 d两组的VAS评分无明显差异(P>0.05)。3组患者在膝关节的活动度和HSS评分比较中,相对术前,3组均有改善;组间B、C两组在术后5 d、10 d的评价结果均优于A组(P<0.05),3组在改善膝关节HSS功能评分和提高膝关节活动度方面,C组>B组>A组。结论:损伤灵软膏联合ERAS对TKA术后肿痛有明显疗效,进一步改善膝关节功能,促进患者康复。

Objective:To explore the clinical efficacy of enhanced recovery after surgery(ERAS)combined with self-prepared Sunshangling Ointment in the perioperative period of total knee arthroplasty(TKA).Methods:A total of 90 patients who underwent unilateral TKA treatment were randomly divided into the blank group,the control group and the treatment group,with 30 cases in each group.The blank group received routine treatment during the perioperative period,whereas the control group received ERAS treatment,and the treatment group was externally applied with Sunshangling Ointment on the first day after the surgery on the treatment basis of the control group.The result data were recorded for 10 days.The score of VAS,the average circumference of the affected limb,the score of HSS and the active flexion and extension range of motion(ROM)of the knee joint were observed and compared in the three groups after the treatment.Results:In terms of the comparison of VAS score and the circumference of the affected limb,the result scores of the control group and the treatment group were better than those of the blank group on 3 d,5 d and 10 d after the surgery(P<0.05);there were no statistical difference in VAS score between the control group and the treatment group on 3 d after the surgery(P>0.05).In terms of the comparison of ROM of the knee joint and HSS score,they were all improved after the surgery compared with those before the surgery in the three groups;the evaluation results of the control group and the treatment group were better than those of the blank group on 5d and 10 d after the surgery(P<0.05);the three groups were in descending order of the treatment group,the control group and the blank group in terms of improving HSS score and ROM of knee joint.Conclusion:The combination of Sunshangling Ointment and ERAS has a significant effect on swelling and pain after TKA,which can further improve the knee joint function and promote the recovery of the patients.