高压氧联合揿针对跟骨骨折患者疼痛的影响

Effect of hyperbaric oxygen combined with thumb-tack needle therapy on pain in patients with calcaneal fracture

目的研究高压氧联合揿针对跟骨骨折患者围手术期急性疼痛的控制作用。方法本研究为随机对照试验。将2021年10月至2022年8月入住烟台市烟台山医院创伤骨科的跟骨骨折患者90例作为研究对象,按照随机数字表法分为3组,各30例。对照组男20例、女10例,年龄(36.9±6.3)岁,采取常规镇痛措施,如药物镇痛、冷敷等;高压氧组男21例、女9例,年龄(37.4±5.7)岁,在对照组基础上进行高压氧治疗;高压氧联合揿针组男19例、女11例,年龄(37.2±5.9)岁,在高压氧组基础上进行揿针治疗。对比3组患者术前及术后不同时间点的疼痛数字评分法(NRS)评分情况。采用方差分析、SNK-q检验、χ^(2)检验。结果3组患者术前1 d[(5.3±0.9)分、(4.1±1.1)分、(2.6±0.8)分]、术后1 d静息痛评分[(7.5±1.2)分、(5.5±1.2)分、(3.7±1.2)分]及术后7 d运动痛评分[(6.1±0.6)分、(4.2±0.7)分、(2.8±0.6)分]比较,差异均有统计学意义(均P<0.001);与对照组相比,高压氧组、高压氧联合揿针组术前1 d[(4.1±1.1)分、(2.6±0.8)分比(5.3±0.9)分]、术后1 d静息痛评分[(5.5±1.2)分、(3.7±1.2)分比(7.5±1.2)分]、术后7 d运动痛评分[(4.2±0.7)分、(2.8±0.6)分比(6.1±0.6)分]显著较低,差异均有统计学意义(均P<0.05);高压氧联合揿针组术前1 d、术后1 d静息痛评分及术后7 d运动痛评分[(2.6±0.8)分、(3.7±1.2)分、(2.8±0.6)分]均低于高压氧组[(4.1±1.1)分、(5.5±1.2)分、(4.2±0.7)分],差异均有统计学意义(均P<0.05)。结论高压氧联合揿针治疗跟骨骨折,能有效缓解围手术期疼痛,提高生活质量,促进患者快速康复。

Objective To study the effect of hyperbaric oxygen combined with thumb-tack needle on the control of perioperative acute pain in patients with calcaneal fracture.Methods This study was a randomized controlled trial.Ninety cases of calcaneal fracture who were admitted to Department of Traumatic Orthopedics,Yantai Mountain Hospital from October 2021 to August 2022 were selected and were divided into 3 groups with 30 cases in each group according to the random number table method.In the control group,20 males and 10 females,aged(36.9±6.3)years,were treated with conventional analgesic measures,such as drug analgesia and cold compress.In the hyperbaric oxygen group,21 males and 9 females,aged(37.4±5.7)years,were treated with hyperbaric oxygen on the basis of the control group.In the combined group,19 males and 11 females,aged(37.2±5.9)years,were treated with thumb-tack needle on the basis of the hyperbaric oxygen group.The Numerical Rating Scale(NRS)scores of the three groups were compared before and at different time points after surgery.Analysis of variance,SNK-q test,andχ^(2) test were used.Results There were statistically significant differences in the resting pain score 1 day before surgery[(5.3±0.9)points vs.(4.1±1.1)points vs.(2.6±0.8)points]and 1 day after surgery[(7.5±1.2)points vs.(5.5±1.2)points vs.(3.7±1.2)points]and in the exercise pain score 7 days after surgery[(6.1±0.6)points vs.(4.2±0.7)points vs.(2.8±0.6)points](all P<0.001).Compared with those in the control group,the resting pain scores 1 day before surgery[(4.1±1.1)points,(2.6±0.8)points vs.(5.3±0.9)points]and 1 day after surgery[(5.5±1.2)points,(3.7±1.2)points vs.(7.5±1.2)points]and the exercise pain scores[(4.2±0.7)points,(2.8±0.6)points vs.(6.1±0.6)points]7 days after surgery in the hyperbaric oxygen group and the combined group were significantly lower,with statistically significant differences(all P<0.05).The resting pain scores 1 day before surgery and 1 day after surgery and the exercise pain score 7 days after surgery[(2.6±0.8)points,(3.7±1.2)points,and(2.8±0.6)points]in the combined group were lower than those in the hyperbaric oxygen group[(4.1±1.1)points,(5.5±1.2)points,and(4.2±0.7)points],with statistically significant differences(all P<0.05).Conclusion Hyperbaric oxygen combined with thumb-tack needle therapy can effectively relieve the perioperative pain,improve the quality of life,and promote rapid and good recovery for patients with calcaneal fracture.