摘要
目的 研究冷敷联合氨甲环酸(TXA)对全膝关节置换(TKA)术后早期局部反应的影响。方法 采用回顾性分析方法,选取2017年月1月至2021年6月收治的三亚中心医院(海南省第三人民医院)的90例全膝关节置换术患者作为研究对象,按照治疗方式分为A组(n=30)、B组(n=30)、C组(n=30)。A组于TKA术前静脉滴注1 g TXA;B组在A组治疗基础上于切口关闭时将1 g TXA输注于关节腔内;C组在B组治疗基础上于TKA术后予以持续冷敷12 h。比较3组术中失血量、手术时间、术后引流量与术后不同时间段疼痛评分、关节活动度(ROM)、两股部周径差。结果 3组患者术中失血量、手术时间比较,差异无统计学意义(P> 0.05);较A组,B、C组术后引流量更低,且C组术后低于B组,差异均有统计学意义(P <0.05)。3组患者术后48 h疼痛评分均明显低于术后24 h,差异均有统计学意义(P <0.05);较A组,B、C组术后24、48 h疼痛评分更低,且C组术后24、48 h低于B组,差异均有统计学意义(P <0.05)。3组患者术后7 d ROM均明显高于术后3 d,差异均有统计学意义(P <0.05);较A组,B、C组术后3、7 d ROM更高,且C组术后3、7 d ROM明显高于B组,差异均有统计学意义(P <0.05)。3组患者术后7 d两股部周径差低于术后3 d,差异均有统计学意义(P <0.05);较A组,B、C组术后3、7 d两股部周径差更低,且C组术后3、7 d低于B组,差异均有统计学意义(P <0.05)。结论 冷敷联合TXA可有效缓解TKA术后早期局部反应,减轻患者术后疼痛及出血,改善其关节活动度,促使其快速康复。
Objective To study the effect of cold compress combined with tranexamic acid(TXA)on early local reaction after total knee arthroplasty(TKA).Methods A retrospective analysis was conducted in 90 patients with total knee replacement who were admitted to Sanya Central Hospital(the Third People's Hospital of Hainan Province from January 2017 to June 2021.They were divided into group A(n=30),group B(n=30)and Group C(n=30)according to treatment methods.Group A received intravenous infusion of 1 g TXA before TKA.In group B,1 g TXA was injected into the joint cavity when the incision was closed on the basis of the treatment in group A.Group C was treated with continuous cold compress for 12 hours after TKA on the basis of group B.The intraoperative blood loss,operative time,postoperative drainage volume,pain score,range of motion(ROM)and circumference difference of the two extremities were compared among the three groups.Results There were no significant differences in intraoperative blood loss and operation time among the three groups(P>0.05).Compared with group A,postoperative drainage volume in groups B and C was lower,and group C was lower than group B after operation,the differences were statistically significant(P<0.05).The pain scores of the three groups at 48 hours after operation were significantly lower than those at 24 hours after operation,and the differences were statistically significant(P<0.05).Compared with group A,the pain scores of group B and C were lower at 24 and 48 hours after operation,and the differences were statistically significant(P<0.05).The ROM of the three groups at 7 days after operation was significantly higher than that at 3 days after operation,and the difference was statistically significant(P<0.05).The ROM in group C at 3 and 7 days after operation was significantly higher than that in group B,and the difference was statistically significant(P<0.05).The difference in circumference between the two thighs of the three groups at 7 days after operation was lower than that at 3 days after o
作者
吴兴源
张国如
陈尉
郑德攀
潘辉龙
WU Xing-yuan;ZHANG Guo-ru;CHEN Wei(Department of Bone and Joint Surgery,Sanya Central Hospital(the Third People's Hospital of Hainan Province),Sanya Hainan 572000,China)
出处
《临床和实验医学杂志》
2022年第8期853-856,共4页
Journal of Clinical and Experimental Medicine
基金
海南省自然科学基金资助项目(编号:817332)。
关键词
全膝关节置换术
冷敷
氨甲环酸
局部反应
疼痛
Total knee replacement
Cold compress
Tranexamic acid
Local reaction
The pain
