来源：风湿病与关节炎,2021,10（6）：10-13,18.

腕踝针对膝内翻畸形患者全膝关节置换术后镇痛效果的临床观察（临床研究）

邹慧华^１，李海婷²，谢丽玉¹，庞书勤²

　　【摘　要】目的：观察腕踝针对膝内翻畸形患者全膝关节置换术后的镇痛效果。方法：将74例膝骨关节炎伴内翻畸形行全膝关节置换手术的患者按照随机数字表法分为治疗组和对照组，每组37例。对照组给予常规镇痛，治疗组在常规镇痛的基础上加用腕踝针。埋针时间为CPM机被动锻炼前，留针4 h，每日1次，共干预7 d，观察14 d。记录2组患者干预前后疼痛数字评分法（NRS）评分、睡眠质量、关节活动度、镇痛过程中发生的不良反应等指标。结果：最终纳入有效例数71例，其中治疗组35例，对照组36例。术后第3，5，7，14天，治疗组静息状态和被动锻炼NRS评分与入院当天比较，差异有统计学意义（P < 0.05）；术后第5，7，14天，对照组静息状态疼痛和被动锻炼NRS评分与入院当天比较，差异有统计学意义（P < 0.05）。术后第3，5，7，14天，治疗组静息状态和被动锻炼NRS评分明显低于对照组，差异有统计学意义（P < 0.05）。术后第14天，2组患者主动关节活动度与入院当天比较，差异有统计学意义（P < 0.05）；2组间比较，差异有统计学意义（P < 0.05）。术后第14天，2组PSQI评分比较，差异有统计学意义（P < 0.05）。治疗组发生不良反应的例数少于对照组，2组比较，差异有统计学意义（P < 0.05）。结论：腕踝针对膝内翻畸形患者全膝关节置换术后具有镇痛效果，同时具有价廉、不良反应少等优点。

　　【关键词】　膝骨关节炎；全膝关节置换术；腕踝针；内翻畸形；疼痛

Clinical Observation of Wrist-ankle Acupuncture for Patients with Knee Varus After Total Knee Arthroplasty

ZOU Hui-hua,LI Hai-ting,XIE Li-yu,PANG Shu-qin

　　【ABSTRACT】Objective:To observe the analgesic effect of wrist-ankle acupuncture on patients with genu varus after total knee arthroplasty.Methods:Seventy-four cases with knee osteoarthritis and varus were randomly divided into a treatment group and a control group after total knee arthroplasty,37 cases in each group.The control group was given conventional analgesia,and the treatment group was given wrist-ankle acupuncture on the basis of conventional analgesia.Before CPM passive exercise,the needle was kept for 4 hours,once a day for 7 days,and the observation lasted for 14 days.NRS,sleep quality,range of knee motion and adverse reactions were recorded before and after the intervention.Results:Seventy-one cases were included,including 35 cases in the treatment group and 36 cases in the control group.On the 3rd,5th,7th and 14th days after operation,the NRS of resting state and passive exercise in the experimental group were significantly different from those on the day of admission（P < 0.05）;On the 5th,7th and 14th days after operation,the NRS of resting state and passive exercise in the control group were significantly different from those on the day of admission（P < 0.05）.On the 1st,3rd,5th,7th and 14th days after operation,the NRS of resting state and passive exercise in the experimental group were significantly lower than those in the control group（P < 0.05）.On the 14th day after operation,the active range of knee motion of the two groups was significantly different from that on the day of admission（P < 0.05）;The difference between the two groups was statistically significant（P < 0.05）.On the 14th day after operation,there was significant difference in PSQI scores between the two groups（P < 0.05）.The number of adverse reactions in the experimental group was few than that in the control group,and the difference was statistically significant（P < 0.05）.Conclusion:Wrist-ankle acupuncture has an analgesic effect for patients with knee varus after total knee arthroplasty,and has the advantages of low price and less adverse reactions.

　　【Keywords】 knee osteoarthritis;total knee arthroplasty;wrist-ankle acupuncture;varus deformity;pain