Analysis of Effect of Moxibustion Combined with Conventional Treatment on Promoting Early Recovery After Total Hip Arthroplasty
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摘要:
目的:观察艾灸联合常规疗法在促进全髋关节置换术(THR) 后患者早期康复方面的效果。方法:将110 例THR 术后患者随机分为对照组和观察组各55 例。2 组均给予术后持续48 h 硬膜外镇痛,口服氨酚曲马多片、皮下注射低分子肝素钙注射液,共用药7 d,并给予护理康复措施。观察组加用艾灸,共治疗14 d。于术后3、5、7 和10 d 应用视觉模拟评分法(VAS)评价疼痛程度,于术后1、3、5、7 d 计算下肢周径差以评价下肢的肿胀程度,于术后6 周评价髋关节功能,应用彩色多普勒超声检查测量下肢血流速度,并记录2 组患者深静脉血栓(DVT)、下肢麻木、下肢皮色变化和皮温下降的发生情况和血流缓慢情况。结果:观察组术后3 d、5 d、7 d 和10 d 的VAS 评分均低于对照组(P<0.01)。观察组术后3 d、5 d 和7 d 的下肢周径差均小于对照组(P<0.01)。术后6 周,观察组髋关节功能的恢复情况优于对照组(P<0.05)。观察组麻木、血流缓慢、皮色改变、皮温下降发生率均低于对照组,差异均有统计学意义(P<0.05),DVT 发生率虽也低于对照组,但组间比较,差异无统计学意义(P>0.05)。结论:在常规治疗和护理康复措施的基础上加用艾灸能有效减轻THR 术后肿痛、促进血液循环,减少了术后DVT形成的风险,促进了髋关节功能恢复,有利于早期康复。
Abstract:
Abstract: Objective: To observe the effect of the therapy of moxibustion combined with conventional treatment on promoting early recovery of patients after total hip arthroplasty(THR). Methods: A total of 110 cases of patients who underwent THR were randomly divided into the control group and the observation group,55 cases in each group. Both groups were given epidural analgesia for 48 h after surgery, oral paracetamol tramadol tablets, subcutaneous injection of lowmolecular- weight heparin calcium,and were treated for seven days,and nursing rehabilitation measures also involved. The observation group was additionally treated with moxibustion for 14 days. Three,five,seven and ten days after surgery,the Visual Analogue Scale(VAS) was used to evaluate pain. One, three, five and seven days after surgery, the difference of peripheral diameter of lower extremities was calculated to evaluate the degree of the swelling. Six weeks after surgery,the hip function was evaluated, the blood flow velocity of lower extremities was measured by color Doppler ultrasonography, and the occurrence of deep vein thrombosis(DVT),numbness and skin color change of lower extremities,and decline of skin temperature as well as blood slowness were recorded in both groups. Results: Three, five, seven and ten days after surgery, the VAS scores in the observation group were lower than those in the control group (P<0.01). Three, five and seven days after surgery,the difference of peripheral diameter of lower extremities in the observation group was lower than that in the control group(P<0.01). Six weeks after surgery,the hip function recovered better in the observation group than the control group(P<0.05). The incidence of numbness, slow blood flow, change of skin color and decline of skin temperature in the observation group was lower than that in the control group,differences being significant(P<0.05);the incidence of DVT in the observation group was lower than that in the control group,there being no significant difference(P> 0.05). Conclusion: The additional application of moxibustion based on conventional treatment and nursing rehabilitation measures,can effectively reduce postoperative swelling and pain after THR,promote blood circulation,reduce the risk of DVT and promote the functional recovery of hip joint,and is beneficial to early rehabilitation.