| 收肌管阻滞术联合经皮穴位电刺激用于全膝关节置换术后的临床效果 |
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投稿时间：2021-03-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 葛梅 |
GE Mei |
浙江中医药大学附属江南医院 杭州萧山中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou 311200, Zhejiang, China |
316597850@qq.com |
| 翟晓军 |
ZHAI Xiao-jun |
浙江中医药大学附属江南医院 杭州萧山中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou 311200, Zhejiang, China |
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| 李勇 |
LI Yong |
浙江中医药大学附属江南医院 杭州萧山中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou 311200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第8期，第750-754页 |
| DOI：10.12200/j.issn.1003-0034.2021.08.011 |
| 基金项目:杭州市卫生科技计划项目（编号：B20200155） |
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中文摘要:
目的：探讨收肌管阻滞术（addcutor canal block，ACB）联合经皮穴位电刺激（transcutaneous electrical acupoint stimulation，TEAS）在全膝关节置换术（total knee arthroplasty，TKA）术后镇痛及对早期功能锻炼的效果。
方法：选取2019年1月至2020年8月初次单侧行TKA的患者84例，其中男45例，女39例；年龄66~77（72.8±8.9）岁；身体质量指数（body mass index，BMI）19~25（23.6±3.5） kg/m2。按照随机数字表法将患者分为收肌管阻滞术联合经皮穴位电刺激组（TEAS+ACB组）和单纯收肌管阻滞术组（ACB组），每组42例。ACB组术中实施ACB，TEAS+ACB组在ACB基础上于术后第1~7天行双下肢TEAS。记录并比较两组术后6，12，24，48，72 h的疼痛视觉模拟评分（visual analogue scale，VAS），术后第1，2，3，7天的膝关节功能，术后第7天膝关节活动度与住院天数。
结果：TEAS+ACB组VAS评分在静息、活动状态下术后6，12 h与ACB组相比差异无统计学意义（P>0.05），在术后24，48，72 h均低于ACB组（P<0.05）。TEAS+ACB组膝关节活动度在术后第1天与ACB组相比差异无统计学意义（P>0.05），在术后第2，3，7天均大于ACB组（P<0.05）。TEAS+ACB组住院天数小于ACB组，术后第7天膝关节活动度大于ACB组（P<0.05）。
结论：TEAS联合ACB较单纯的ACB有更好的术后镇痛效果，促进患者早期功能锻炼，对TKA术后镇痛是安全、有效的。 |
| 【关键词】全膝关节置换术 收肌管阻滞术 经皮穴位电刺激 镇痛 |
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| Clinical efficacy of adductor canal blockade combined with transcutaneous electrical acupoint stimulation for total knee arthroplasty |
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ABSTRACT
Objective: To evaluate the efficacy of adductor canal block(ACB) combined with transcutaneous electrical acupoint stimulation(TEAS)for postoperative analgesia and early functional exercise after total knee arthroplasty(TKA).
Methods: A total of 84 patients underwent primary unilateral TKA from January 2019 to August 2020 were selected,including 45 males and 39 females,aged 66-77 (72.8±8.9) years;body mass index (BMI) was for 19-25 (23.6±3.5) kg/m2. They were divided into adductor canal block combined with transcutaneous electrical acupoint stimulation group(TEAS+ACB group)and simple adductor canal block group(ACB group) according to random number table method,42 cases in each group. ACB was performed in ACB group during the operation. And TEAS was performed in TEAS+ACB group on bilateral lower limbs in 1-7 days postoperative on the basis of ACB. VAS scores at 6,12,24,48,72 h after surgery,knee function at 1,2,3,7 days after surgery,knee motion at 7 days after surgery and length of hospitalization days were recorded and compared between the two groups.
Results: There were no significant differences in VAS of rest pain and activity pain in postoperative 6,12 h between two groups (P>0.05),but the VAS of TEAS+ACB group was lower at 24,48,72 h after surgery(P<0.05). There was no significant difference in at 1 day postoperatively between two groups(P>0.05),but the knee function of TEAS+ACB group was better than that of the ACB group in 2,3,7 days postoperatively(P<0.05). The length of hospitalization days in were less than in ACB group. On the 7th day after operation,the knee motion of TEAS+ACB group was greater than that of the ACB group(P<0.05).
Conclusion: TEAS combined with ACB has a better postoperative analgesic efficacy than simple ACB,and can promote early functional exercise of patients. It is safe and effective for postoperative analgesia after TKA. |
| KEY WORDS Total knee arthroplasty Adductor canal block Transcutaneous electrical acupoint stimulation Analgesia |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 葛梅,翟晓军,李勇.收肌管阻滞术联合经皮穴位电刺激用于全膝关节置换术后的临床效果[J].中国骨伤,2021,34(8):750~754 |
| 英文格式: | GE Mei,ZHAI Xiao-jun,LI Yong.Clinical efficacy of adductor canal blockade combined with transcutaneous electrical acupoint stimulation for total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(8):750~754 |
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