经皮穴位电刺激联合多模式镇痛对全膝关节置换术后近远期关节功能的影响

Effects of Transcutaneous Electrical Acupoint Stimulation Combined with Multimodal Analgesia on Short-term and Long-term Joint Function after Total Knee Arthroplasty

目的探讨经皮穴位电刺激联合多模式镇痛对全膝关节置换术后近、远期关节功能的影响。方法采用随机数字表法将110例接受全膝置换术的患者分为治疗组与对照组各55例。对照组应用多模式镇痛方案,治疗组在多模式镇痛方案的基础上联合经皮穴位电刺激,记录并分析2组患者术前及术后不同时间点的术肢疼痛视觉模拟评分法(VAS)评分、痛阈值、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、健康调查12条简表(SF-12)评分。结果术后3、7 d,治疗组VAS评分低于对照组(P<0.05)。术后7 d,治疗组患肢痛阈值高于对照组(P<0.05)。术后1、2、4、12周,治疗组WOMAC评分低于对照组(P<0.05)。术后4、12周,治疗组SF-12评分高于对照组(P<0.05)。结论经皮穴位电刺激联合多模式镇痛能改善全膝置换术后疼痛,促进近、远期关节功能恢复,且对术后近期关节功能的改善作用较远期更为显著。

Objective To investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)combined with multimodal analgesia on short-term and long-term joint function after total knee arthroplasty(TKA).Methods Totally 110 patients with TKA were divided into the treatment group and the control group according to random number table method,with 55 cases in each group.The control group was treated with multimodal analgesia,and the treatment group was treated with TEAS on the basis of multimodal analgesia.The VAS score,pain threshold value,WOMAC score and SF-12 score of the two groups before and at different time points after operation were recorded and analyzed.Results The VAS score of the treatment group was lower than that of the control group on the 3rd and 7th day after operation(P<0.05).On the 7th day after operation,the knee pain threshold in the treatment group was higher than that in the control group(P<0.05).The WOMAC score of the treatment group was lower than that of the control group at the 1st,2nd,4th and 12th week after operation(P<0.05).At the 4th and 12th week after operation,the SF-12 score of the treatment group was higher than that of the control group(P<0.05).Conclusion TEAS combined with multimodal analgesia can relieve the pain after TKA,and promote the recovery of joint function in the short term and long term,and the improvement effect in the short term is more obvious than that in the long term.