| 全华山,陈 能,吕 燃,曹建斌,莫卫海,李 云,王雄庆,宋伊莎.徒手淋巴引流对全膝关节置换术后肢体肿胀程度及血液炎性指标的影响[J].,2020,(14):2781-2785 |
| 徒手淋巴引流对全膝关节置换术后肢体肿胀程度及血液炎性指标的影响 |
| Effect of Manual Lymphatic Drainage on Swelling Degree of Lower Limbs and Inflammatory Indicators after Total Knee Arthroplasty |
| 投稿时间：2020-02-28 修订日期：2020-03-24 |
| DOI：10.13241/j.cnki.pmb.2020.14.040 |
| 中文关键词: 徒手淋巴引流 膝骨关节炎 全膝关节置换术 肤温 肢体肿胀程度 血液炎性指标 |
| 英文关键词: Manual lymphatic drainage Knee osteoarthritis Total knee arthroplasty Skin temperature Degree of limb swelling Hematoinflammatory index |
| 基金项目:广东省科技计划项目（2017ZC0161；2017ZC0197）；珠海市医疗卫生科技计划项目（20181117E030048） |
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| 中文摘要: |
| 摘要 目的：探讨徒手淋巴引流对全膝关节置换术（TKA）后肢体肿胀程度及血液炎性指标的影响。方法：选取2018年12月～2019年12月广东省中医院珠海医院收治的拟行初次TKA手术的膝骨关节炎（KOA）患者70例，随机分为观察组和对照组各35例，对照组按TKA术后常规方案治疗，观察组在对照组基础上增加徒手淋巴引流术，比较两组术前，术后1 d、4 d、7 d、2周、4周、8周肤温、肿胀程度及血液炎性指标，评估患者术后康复情况及不良事件发生情况。结果：两组术后2周肤温低于术后7 d，术后4周低于术后2周，术后8周低于术后4周，差异均有统计学意义（P＜0.05）。观察组术后2周、4周、8周肤温均低于对照组，差异均有统计学意义（P＜0.05）。两组术后1 d肢体肿胀度低于术后4 d，术后2周低于术后7 d，术后4周低于术后2周，术后8周低于术后4周，差异均有统计学意义（P＜0.05）。观察组术后7 d、2周、4周、8周肢体肿胀度均低于对照组，差异均有统计学意义（P＜0.05）。两组术后4 d白细胞计数（WBC）水平低于术后1 d，而超敏C反应蛋白（hs-CRP）水平高于术后1 d；两组术后7 d WBC、hs-CRP及血沉（ESR）水平均低于术后4 d，且术后2周低于术后7 d，术后4周低于术后2周，术后8周低于术后4周，差异均有统计学意义（P＜0.05）。观察组术后7 d hs-CRP水平均低于对照组，术后2周、4周、8周hs-CRP、ESR水平均低于对照组，差异均有统计学意义（P＜0.05）。结论：TKA术后应用徒手淋巴引流手法能有效减轻患者术后肢体肿胀程度，缩短炎症周期，降低炎症反应，在临床上值得推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of manual lymphatic drainage on swelling degree of lower limbs and inflammatory indicators after total knee arthroplasty(TKA). Methods: 70 patients with knee osteoarthritis (KOA) who were admitted to Zhuhai Hospital of Guangdong Hospital of Traditional Chinese Medicine from December 2018 to December 2019 for the first TKA operation were randomly divided into the observation group and the control group with 35 cases in each group. The control group was treated according to the routine plan after TKA operation, and the observation group was treated with manual lymphatic drainage on the basis of the control group. The skin temperature, swelling degree and blood inflammation index of the two groups were compared before operation, 1 d, 4 d, 7 d, 2 weeks, 4 weeks and 8 weeks after operation and the rehabilitation and adverse events were evaluated. Results: The skin temperature in the two groups 2 weeks after operation was lower than 7 d after operation, 4 weeks after operation lower than 2 weeks after operation and 8 weeks after operation lower than 4 weeks after operation, the difference was statistically significant (P<0.05). The skin temperature of the observation group was lower than that of the control group at 2 weeks, 4 weeks and 8 weeks after operation, the difference was statistically significant (P<0.05). The swelling degree of limbs in the two groups 1 d after operation was lower than 4 d after operation, 2 weeks after operation lower than 7 d after operation,4 weeks after operation lower than 2 weeks after operation and 8 weeks after operation lower than 4 weeks after operation, the difference was statistically significant (P<0.05). The swelling degree of limbs of the observation group was lower than that of the control group at 7 d, 2weeks, 4 weeks and 8 weeks after operation, the difference was statistically significant (P<0.05). The WBC level in the two groups 4 d after operation was lower than 1d after operation, while the hs-CRP level was higher than 1 d after operation; the WBC, hs-CRP and ESR levels in the two groups 7 d after operation were lower than 4 d after operation, 2 weeks after operation lower than 7 d after operation, 4 weeks after operation lower than 2 weeks after operation and 8 weeks after operation lower than 4 weeks after operation, the difference was statistically significant (P<0.05). The levels of hs-CRP in the observation group 7d after operation was lower than that of the control group, and levels of hs-CRP and ESR in the observation group at 2 weeks, 4 weeks, 8 weeks after operation were lower than that of the control group, the difference was statistically significant (P<0.05). Conclusion: Application of manual lymph drainage after TKA can effectively reduce the degree of postoperative limb swelling, shorten the inflammatory cycle and reduce the inflammatory response, which is worth popularizing in clinical practice. |
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