【摘要】 目的:探讨人工全髋关节置换术后冰毯机持续加压冰敷与局部冰敷两种物理降温方法对术后早期髋关节功能的影响。方法:选取术前检查一般情况良好,行人工全髋关节置换术者共120例,其中60例创伤患者随机分为观察1组30例(30髋)和对照1组30例(30髋),60例非创伤患者随机分为观察2组30例(35髋)和对照2组30例(33髋)。两观察组予以冰毯机持续加压冰敷,两对照组予以伤口局部冰敷。术后均行主动关节功能锻炼及持续被动运动(CPM)。比较各组视觉模拟疼痛评分(VAS评分)、术后24、48 h引流量、拔除引流管时间、Harris髋关节功能评分。结果:术后观察组6、12、24、48 h VAS评分均低于对照组,术后24、48 h引流量少于对照组,观察组均可在术后48 h内拔除引流管,术后1、3、6周髋关节功能Harris评分明显高于对照组,P均<0.05。两组均未出现假体脱位、深部感染、下肢深静脉血栓等并发症。结论:人工全髋关节置换术后冰毯机持续加压冰敷在术后早期控制疼痛、减少出血、改善髋关节功能方面优于传统局部冰敷,值得临床推广。更多还原

【Abstract】 Objective: To compare the influences of the two physical cooling methods: cooling blanket and local icing on the early postoperative hip function after total hip arthroplasty.Methods: 120 patients who were in good conditions and postoperative of total hip replacement were selected,then they were divided into two groups according to whether they were trauma or not trauma.Each group consisted 60 members.30 patients were respectively chosen from each group constituted observation group,and were given cooling blanket physical cooling.The rest 60 patients were regarded as controlling group and were applied local icing to the wound.All of the patients proceeded active joint function exercise and continuous passive sport(CPM) after their operations.Their Values Added Service(VAS rating),capacities of lead flow at 24,48 h after operations,the time of pulling out the tube and Harris hip functional scores were compared.Results: The VAS scores of 6,12,24,48 h in observation groups were lower than those of the control groups while the drainage capacities of their 24,48 h in the observation groups were less than that in control groups.In the patients from the observation groups the tube could be pulled out in 48 h and their 1,3,6 weeks Harris functional score were significantly higher than those of the control groups,P<0.05.There was no complication in any group such as prosthesis dislocation,deep infection or lower limb deep vein thrombosis.Conclusion: Cooling blanket method used in the early postoperative could reduce pain and haemorrhage and improve hip function,which is more effective than local icing.更多还原