摘要
目的观察经皮穴位电刺激对单侧全膝关节置换术(TKA)后患者远期关节功能的疗效,并分析患者术后并发下肢肌间静脉血栓(MCVT)可能的影响因素。方法纳入接受单侧TKA患者100例,随机分为试验组和对照组各50例。对照组予TKA围手术期常规方案,试验组在此基础上予经皮穴位电刺激,每次30 min,每日1次,应用至术后7 d。观察2组术后不同时点疼痛视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及术后7 d术肢MCVT发生情况。发生MCVT者纳入MCVT组,未发生者纳入正常组,统计可能影响MCVT发生的因素,并进行单因素和多因素二元Logistic回归分析,筛选独立影响因素。结果试验组脱落3例,对照组脱落1例。术后不同时点与对照组比较,试验组术后3、7 d术肢膝关节活动状态下VAS评分低于对照组(P<0.05),试验组术后2、4、12周WOMAC评分低于对照组(P<0.05),且组内均呈逐渐降低趋势。术后出现MCVT 21例(21.9%),未出现MCVT 75例(78.1%)。二元Logistic回归分析显示,手术时间、术后下地时间、术前血清D-二聚体水平是TKA术后并发MCVT的独立危险因素,经皮穴位电刺激是重要影响因素。结论经皮穴位电刺激可缓解TKA术后活动痛,促进远期关节功能恢复,减少MCVT。术前D-二聚体水平高、手术时间长和下地时间晚的患者术后并发MCVT的风险较高。
Objective To observe the curative effect of transcutaneous electrical acupoint stimulation on longterm joint function after unilateral total knee arthroplasty(TKA);To analyze the possible influencing factors of lower extremity muscular calf vein thrombosis(MCVT).Methods Totally 100 patients receiving unilateral TKA were included and randomly divided into experimental group(50 cases)and control group(50 cases).The control group was treated with the routine TKA during the perioperative period,and the experimental group was treated with transcutaneous electrical acupoint stimulation,once a day,30 minutes each time,until 7 days after surgery.Visual analogue scale(VAS),Western Ontario and McMaster University Osteoarthritis Index(WOMAC)at different time points and MCVT of operative limb 7 days after surgery were observed in 2 groups.Patients with postoperative MCVT were included in the MCVT group,while those without MCVT were included in the normal group.The factors that might affect the occurrence of MCVT were analyzed,and univariate and multivariate binary Logistic regression analysis was performed to screen independent influencing factors.Results There were 3 cases of shedding in the experimental group and 1 case in the control group.The VAS score of the experimental group was lower than that of the control group at 3 and 7 days after surgery(P<0.05),and the WOMAC score at 2,4 and 12 weeks after surgery was lower than that of the control group(P<0.05),and showed a gradually decreasing trend within the group.21 patients(21.9%)had MCVT and 75 patients(78.1%)had no MCVT.Binary Logistic regression analysis showed that time of operation,time of postoperative ambulation and preoperative serum D-dimer level were independent risk factors for MCVT after TKA,and transcutaneous electrical acupoint stimulation was an important factor.Conclusion Transcutaneous electrical acupoint stimulation can relieve the pain after TKA operation,promote the long-term recovery of joint function and reduce the occurrence of MCVT.Patients with h
作者
白天宇
李紫阁
邱佳明
王宏杰
危一飞
王舒娅
温冠楠
程桯
BAI Tianyu;LI Zige;QIU Jiaming;WANG Hongjie;WEI Yifei;WANG Shuya;WEN Guannan;CHENG Ting(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Beijing Key Laboratory of Traditional Chinese Medicine Bone-setting Technology,Beijing 100102,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2023年第10期151-156,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
首都卫生发展科研专项项目(首发2022-2-4162)。
关键词
全膝关节置换术
经皮穴位电刺激
静脉血栓形成
total knee arthroplasty
transcutaneous electrical acupoint stimulation
venous thrombosis
