全膝关节置换术患者关节锻炼期间应用不同冷疗方法的效果观察

Observation on the effectiveness of different cold therapy methods during joint exercise in patients undergoing total knee arthroplasty

目的探讨全膝关节置换术患者关节锻炼期间应用不同冷疗方法的效果。方法选取2021年8月-2022年12月行全膝关节置换手术的100例患者为研究对象,采用随机数字表法分为对照组50例和观察组50例,对照组术后关节锻炼期间给予固体冰袋(高聚化合物制成密闭式冰袋300g)冷疗治疗,每次冷疗30min,每天使用3次。观察组术后关节锻炼期间采用PVC内胆、耐水防水防渗漏的康玛士(Kindman)布冰袋进行冰水冷疗,冰水温度在0℃-4℃,每次冷疗30min,每天使用3次。比较两组患者不同冷疗方法治疗后的8h、24h、48h疼痛程度、下肢肿胀程度、关节活动度及关节功能恢复情况。结果观察组冷疗方法治疗后的8h、24h、48h数字疼痛(NRS)评分低于对照组(P<0.05)。观察组术后下肢肿胀发生率低于对照组(P<0.05)。观察组干预后最大屈曲角度和最大伸直角度较对照组明显改善(P<0.05)。观察组干预后膝关节功能量表(HSS)评分和日常生活活动能力(ADL)评分较对照组显著提升(P<0.05)。结论冰水冷疗的设备能有效减轻全膝关节置换术患者关节锻炼期间疼痛感,有效改善膝关节功能,促进患者术后康复,改善患者日常生活能力。

Objective To explore the effectiveness of different cold therapy methods during joint exercise in patients undergoing total knee arthroplasty.Method 100 cases of patients who underwent total knee replacement surgery were selected as study subjects from August 2021 to December 2022.They were randomly divided into control group(n=50)and observation group(n=50)by random number table method.The control group were treated with solid ice packs(300g sealed ice packs made of high polymer compounds)for 30 minutes each time during postoperative joint exercise.The observation group were treated with PVC inner liner,water resistant,waterproof,and leak proof Kindman cloth ice bags were used for ice water cold therapy during postoperative joint exercise.The temperature of the ice water was 0℃-4℃,and each cold therapy lasted for 30 minutes,using it three times a day.The levels of pain at 8,24,and 48 hours and lower limb swelling,joint range of motion,and joint function recovery of two groups were compared.Result The numerical pain(NRS)scores of the observation group at 8 hours,24 hours,and 48 hours after cold therapy were lower than those of the control group(P<0.05).The incidence of postoperative lower limb swelling of observation group were lower than control group(P<0.05).The levels of maximum flexion angle and maximum extension angle of observation group were significantly improved than control group after intervention(P<0.05).The knee joint function scale(HSS)score and activity of daily living(ADL)score of observation group were significantly improved than control group after intervention(P<0.05).Conclusion Ice water cold therapy equipment can effectively alleviate pain during joint exercise in patients undergoing total knee arthroplasty,improve knee joint function,promote postoperative recovery,and improve their daily living ability.