徒手淋巴引流术对急性闭合性踝关节骨折患者术前肿胀程度及血清致痛物质、炎症因子的影响

Effect of manual lymphatic drainage on preoperative swelling,serum algogenic substances and inflammatory factors for patients with acute closed ankle fracture

目的 探讨徒手淋巴引流术对急性闭合性踝关节骨折患者术前肿胀程度及血清致痛物质、炎症因子的影响。方法 将106例急性闭合性踝关节骨折患者分为观察组与对照组,每组53例。给予两组患者常规消肿治疗,同时观察组患者接受徒手淋巴引流术治疗。比较两组患者治疗前后的肿胀程度、疼痛程度、血清致痛物质水平与炎症因子水平,以及术前等待时间。结果 治疗后,两组患者足踝部周径肿胀程度、足踝部体积肿胀程度、足踝部疼痛视觉模拟量表评分,以及血清P物质、5-羟色胺、去甲肾上腺素、肿瘤坏死因子α、超敏C反应蛋白、白细胞介素6水平均低于治疗前,且观察组上述指标均低于对照组,术前等待时间短于对照组(均P<0.05)。结论 在常规消肿治疗基础上应用徒手淋巴引流术,可更有效地减轻急性闭合性踝关节骨折患者的术前肿胀和疼痛程度、炎症反应,缩短术前等待时间。

Objective To investigate the effect of manual lymphatic drainage on preoperative swelling,serum algogenic substances and inflammatory factors for patients with acute closed ankle fracture.Methods A total of 106 patients with acute closed ankle fracture were assigned to observation group or control group,with 53 cases in each group.Routine detumescence therapy was given to both groups;simultaneously,the observation group received manual lymphatic drainage for treatment.The pre-and post-treatment swelling degree,pain degree,levels of serum algogenic substances and inflammatory factors,as well as preoperative waiting time were compared between the two groups.Results After treatment,the swelling degree of foot and ankle circumference,the swelling degree of foot and ankle volume,the score of Visual Analogue Scale for pain of foot and ankle,and the levels of serum substance P,5-hydroxytryptamine,norepinephrine,tumor necrosis factor α,high-sensitivity C-reactive protein,and interleukin 6 in the two groups were lower than those before treatment,and the observation group yielded lower indices mentioned above as compared with the control group;moreover,the preoperative waiting time in the observation group was shorter than that in the control group(all P<0.05).Conclusion Employing manual lymphatic drainage on the basis of routine detumescence therapy can effectively relieve the preoperative degree of swelling and pain,inflammatory responses,and shorten preoperative waiting time of patients with acute closed ankle fracture.