CAJ | 학술논문

目的：探讨低温物理治疗对膝关节置换术后患者疗效的影响。方法：选取2012年12月~2013年12月在我科就诊的膝关节骨性关节炎患者121例，将2013年6~12月的60例患者纳入观察组，2012年12月~2013年5月的61例患者纳入对照组。所有患者完善术前准备后，均在腰麻下行单侧全膝关节置换术，观察组术后持续使用 Cry／ Cuff 低温物理治疗系统，使冰袋温度维持在0~4℃，维持48 h；对照组术后间断使用 Cry／ Cuff 低温物理治疗系统，每次1 h，每天6次，共维持48 h。收集所有患者术后12，24，48 h 的疼痛 VAS 评分，关节肿胀度及引流量。结果：术后不同时间点观察组的疼痛程度均低于对照组，与各个时间点不存在交互效应。术后不同时间点观察组的肿胀程度均低于对照组，与各时间点间存在交互效应。术后不同时间点观察组的引流量均低于对照组，与各时间点间存在交互效应。分析两组内不同时间点的单独效应，观察组术后12 h 与24 h 的引流量比较有统计学意义（P ﹤0．05），但术后24 h 与48 h 的引流量比较则无统计学意义（P ﹥0．05）；对照组术后12 h 与24 h的引流量比较无统计学意义（P ﹥0．05），但术后24 h 与48 h 的引流量比较有统计学意义（P ﹤0．05），提示持续引流可以更快的结束关节腔内的渗出。结论：持续低温物理治疗可以更明显的减轻术后疼痛和肿胀，并更快的结束关节腔内的渗出。
목적：탐토저온물리치료대슬관절치환술후환자료효적영향。방법：선취2012년12월~2013년12월재아과취진적슬관절골성관절염환자121례，장2013년6~12월적60례환자납입관찰조，2012년12월~2013년5월적61례환자납입대조조。소유환자완선술전준비후，균재요마하행단측전슬관절치환술，관찰조술후지속사용 Cry／ Cuff 저온물리치료계통，사빙대온도유지재0~4℃，유지48 h；대조조술후간단사용 Cry／ Cuff 저온물리치료계통，매차1 h，매천6차，공유지48 h。수집소유환자술후12，24，48 h 적동통 VAS 평분，관절종창도급인류량。결과：술후불동시간점관찰조적동통정도균저우대조조，여각개시간점불존재교호효응。술후불동시간점관찰조적종창정도균저우대조조，여각시간점간존재교호효응。술후불동시간점관찰조적인류량균저우대조조，여각시간점간존재교호효응。분석량조내불동시간점적단독효응，관찰조술후12 h 여24 h 적인류량비교유통계학의의（P ﹤0．05），단술후24 h 여48 h 적인류량비교칙무통계학의의（P ﹥0．05）；대조조술후12 h 여24 h적인류량비교무통계학의의（P ﹥0．05），단술후24 h 여48 h 적인류량비교유통계학의의（P ﹤0．05），제시지속인류가이경쾌적결속관절강내적삼출。결론：지속저온물리치료가이경명현적감경술후동통화종창，병경쾌적결속관절강내적삼출。
Objective:To investigate the effect of cryogenics physical therapy on postoperative patients with knee replacement surgery. Methods:From Decem-ber 2012 to December 2013,121 patients diagnosed as knee osteoarthritis were recruited in this study. Patients from June 2013 to December 2013,60 cases as the observation group,and patients from December 2012 to May 2013,61 cases as the control group. All of the patients received unilateral total knee ar-throplasty(TKA),and different types of ice therapies were performed according to the group. The observation group received continuous ice therapy temper-ature was maintained at 0 - 4 ℃ for 48 h with Cry/ Cuff system after operation,while the control group received intermittent ice therapy for 1 hour each time, 6 times per day for 2 days. Clinical evaluation for pain(VAS),swelling and drainage volume were performed. Results:The degree of pain at different time points after the observation group were lower than the control group,there was no interaction with the various time points. The degree of swelling at different time points after the observation group were lower than the control group,the presence of interaction between the point and time. At different time points after the observation group were lower than the control group drainage,there are interactions between the point and time. Separate effects at different time points within the analysis groups,the observation group after 12 h and 24 h of drainage was statistically significant(P ﹤ 0. 05),but after 24 h and 48 h of drainage no comparison statistical significance(P ﹥ 0. 05);the control group after 12 h and 24 h of drainage was not statistically significant(P ﹥ 0. 05),but after 24 h and 48 h of drainage have more statistics significance(P ﹤ 0. 05),prompt continuous drainage can end faster intra - articular effusion. Conclusion:Compared with intermittent,continuous ice therapy has the advantage of relieving post - operative pain and swelling,and reducing intra - articular bleeding, taking effect earlier.