目的 探索冰袋冷敷对膝关节前交叉韧带重建术后关节疼痛肿胀和活动度的影响。方法 回顾性分析自2021年1月—2021年7月在我院因前交叉韧带损伤行前交叉韧带重建术的患者资料,将符合标准的71例行单侧前交叉韧带重建术的患者按住院号的单双号分成2组。其中,对照组38名患者,试验组33名患者。对照组38名患者术后不用冰袋冷敷;试验组33名患者术后采用冰袋冷敷。用视觉模拟评分表评估对照组和试验组患者术前、术后的疼痛,并测量患者的膝关节肿胀程度和活动度。结果 对照组和试验组患者术前视觉模拟评分比较,差异无统计学意义(P>0.05),试验组在术后6、24、48、72小时四个不同的时间点时疼痛视觉模拟评分均明显低于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前关节活动度比较,差异无统计学意义(P>0.05),试验组在术后4、5、6、7天四个不同的时间点时关节活动度优于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前膝关节肿胀程度比较,差异无统计学意义(P>0.05),试验组在术后1、2、3天三个不同的时间点时膝关节肿胀程度低于对照组,差异有统计学意义(P<0.001)。结论 冰袋冷敷能够有效减轻前交叉韧带重建术后膝关节疼痛肿胀并改善关节活动度。

Objective To explore the effect of ice pack cold compress on joint pain,swelling and motion after anterior cruciate ligament reconstruction. Methods The data of patients undergoing anterior cruciate ligament reconstruction due to anterior cruciate ligament injury in our hospital from January 2021 to July 2021 were retrospectively analyzed,and 71 patients who received unilateral anterior cruciate ligament reconstruction meeting the standards were divided into two groups according to the odd and even numbers of hospital admission. There were 38 patients in the control group and 33 patients in the experimental group. Thirty-eight patients in the control group did not use ice packs after surgery. Thirty-three patients in experimental group were treated with ice pack after operation. Visual analogue scale was used to evaluate the preoperative and postoperative pain of the control group and experimental group,and the degree of knee swelling and range of motion were measured. Results There was no significant difference in preoperative visual analogue scale between control group and experimental group (P>0.05). The scores of pain in the experimental group were significantly lower than that in the control group at 6,24,48 and 72 hours after surgery,with statistical significance (P<0.001). There was no significant difference in preoperative range of motion between control group and experimental group(P>0.05), the range of motion of the experimental group was significantly better than that of the control group at four different time points of 4,5,6 and 7 days after operation,with statistical significance(P<0.001). There was no significant difference in the degree of preoperative knee joint swelling between the control group and the experimental group(P>0.05),and the degree of knee joint swelling in the experimental group was lower than that in the control group on,1,2 and 3 days after surgery,three different time points, with statistically significant difference(P<0.001). Conclusions Ice pack cold compress can effectively reduce the pain and swelling of the knee joint after anterior cruciate ligament reconstruction and improve the range of motion of the joint.

目的 研究早、晚期关节镜下前交叉韧带重建术治疗前交叉韧带损伤(ACL)的临床效果。方法 选取我院2017年12月—2019年12月收治的100例ACL损伤患者,根据不同手术治疗时间分为早期重建组(≤3周,54例)和晚期重建组(4～12周,46例)。比较两组术前及术后14周膝关节功能Lysholm及国际膝关节文献委员会(IKDC)评分,分析两组术前及术后14周膝关节活动度及肌力情况,对比两组术后2、4、8周的患膝屈曲角度,比较两组围术期临床指标。结果 两组患者术后均无早期并发症发生,手术切口均Ⅰ期愈合。两组术后14周Lysholm及IKDC评分较治疗前升高(P＜0.05);早期重建组术后14周Lysholm及IKDC评分与晚期重建组比较差异无统计学意义(P＞0.05)。两组术后14周屈曲受限角度、伸膝受限角度及萎缩指数较治疗前降低(P＜0.05);早期重建组术后14周屈曲受限角度、伸膝受限角度及萎缩指数与晚期重建组比较差异无统计学意义(P＞0.05)。早期重建组术前及术后2、4、8周的患膝屈曲角度与晚期重建组比较差异无统计学意义(P＞0.05)。早期重建组疼痛消除时间、肿胀消除时间及关节恢复正常时间显著长于晚期重建组(P＜0.05)。结论 行早、晚期关节镜下前交叉韧带重建术治疗ACL损伤患者的疗效相近,但晚期重建患者术后恢复效果显著,利于改善预后。