耳穴压丸在全膝关节置换患者术后疼痛及早期康复中的应用

Effects of auricular acupressure therapy on postoperative pain and early rehabilitation of patients with total knee arthroplasty

目的探讨耳穴压丸对全膝关节置换患者术后疼痛及早期康复效果的影响。方法采用便利抽样法,于2021年3—6月选取聊城市人民医院骨关节外科全身麻醉复合外周神经阻滞下择期首次行单侧全膝关节置换术的68例患者,根据随机数字法分为观察组35例、对照组33例。两组术后均接受常规疼痛管理及术后早期康复护理,均在术前1 d由中医科医师在耳穴部位粘贴王不留行籽胶布,对照组不采取任何按压操作,观察组按压时间为术前1 d至术后3 d,每天3次,按压频率为60下/min,按压时长为1 min/穴。记录并比较两组术后离开麻醉恢复室即刻及术后4、24、48、72 h镇痛药用量,以及各随访时间点的静息和活动状态的视觉模拟疼痛评分;比较两组患者术后第2、4、7天的膝关节活动度。结果观察组患者术后24、48、72 h的镇痛药用量低于对照组,差异有统计学意义(P<0.05)。观察组患者术后24 h的静息状态的疼痛评分低于对照组,术后24、48、72 h活动状态的疼痛评分低于对照组,差异均有统计学意义(P<0.05)。观察组患者术后第2、4、7天的膝关节活动度高于对照组,差异均有统计学意义(P<0.05)。结论耳穴压丸可减少全膝关节置换患者术后镇痛药用量,降低疼痛程度,促进患者早期康复。

Objective To explore the effect of auricular acupressure therapy on postoperative pain and early rehabilitation of patients with total knee arthroplasty.Methods From March to June 2021,68 patients who underwent unilateral total knee arthroplasty for the first time under general anesthesia combined with peripheral nerve block in Liaocheng People's Hospital were selected by convenient sampling.According to the random number method,the patients were divided into observation group(35 cases)and control group(33 cases).Both groups received routine pain management and early postoperative rehabilitation nursing after operation,and the Chinese medicine doctors pasted the Wangbuliuxing seed adhesive tape at the auricular points one day before operation.The control group did not take any pressing operation.The observation group was pressed at the time of 1 day before operation to 3 days after operation,3 times a day.The pressing frequency was 60 times/min,and the pressing time was 1 minute per acupoint.The dosage of analgesics used immediately after leaving the Anesthesia Recovery Room and at 4,24,48 and 72 hours after operation,as well as the visual analog pain scores of rest and activity at each follow-up time point were recorded and compared between the two groups.The knee range of motion of the two groups on the second,the fourth and seventh days after operation was compared.Results The dosage of patient-controlled intravenous analgesia analgesics in the observation group were lower than those in the control group at 24,48 and 72 hours after operation,with statistically significant differences(P<0.05).The pain score of the patients in the observation group at rest 24 hours after operation was lower than that in the control group,and the pain scores of the patients in the active state at 24,48 and 72 hours after operation were lower than those in the control group,and the differences were statistically significant(P<0.05).The knee range of motion in the observation group were higher than those in the control group on the second,fourth and seventh days after operation,and the differences were statistically significant(P<0.05).Conclusions Auricular acupressure therapy can reduce the dosage of analgesics used after total knee arthroplasty,relieve the degree of pain,and promote the early recovery of patients.