经皮穴位电刺激对全膝置换术后早期反应的影响△

Effect of transcutaneous electrical acupoint stimulation on early reaction secondary to total knee arthroplasty

摘要:

[目的] 探讨经皮穴位电刺激（transcutaneous electrical acupoint stimulation, TEAS） 对全膝关节置换术（total knee ar-throplasty, TKA） 术后早期反应的影响。[方法] 2022 年5 月—2023 年6 月本科收治的KOA 拟行TKA 患者共91 例，按随机数字表法分为两组，46 例在常规治疗的基础上联合应用TEAS 治疗，45 例采用常规治疗，比较两组临床及血液检验指标。[结果] 两组手术时间、总失血量及不良事件发生率的差异均无统计学意义（P＞0.05）。电刺激组术后7 d [(4.5±1.4) vs (5.1±1.3), P=0.018] 和术后14 d [(2.4±1.1) vs (3.9±1.5) , P＜0.001] 活动状态VAS 评分，术后7 d [(2.0±1.1) vs (2.6±1.5), P=0.043] 和术后14 d[(1.0±0.9) vs (1.4±1.1), P=0.033] 静息状态VAS 评分均显著低于常规组。电刺激组术后第14 d 髌上10 cm 周径[(45.3±2.9) cm vs(48.1±4.3) cm, P=0.038] 及膝关节ROM [(122.3±9.3)° vs (115.6±7.4)°, P＜0.001] 均显著优于常规组。检验方面，电刺激组术后第7d 的Fib [(3.8±0.9) s vs (4.3±1.0) s , P=0.027]、D-D [(7.1±15.8) mg/L vs (14.7±23.1) mg/L , P=0.048] 显著低于常规组（P＜0.05），PT时间[(11.5±0.6) s vs (11.2±0.6) s, P=0.026] 显著长于常规组（P＜0.05）。[结论] TEAS 有效减轻TKA 术后早期反应，促进术后康复。

关键词:膝骨关节炎;全膝关节置换术;术后疼痛;经皮穴位电刺激;凝血功能

Abstract:

[Objective] To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the early response after to-tal knee arthroplasty (TKA). [Methods] From May 2022 to June 2023, a total of 91 patients who were undergoing TKA for knee osteoarthri-tis were divided into two groups according to the random number table method. Of them, 46 cases in the TEAS group received TEAS treat-ment on the basis of conventional treatment, while other 45 patients in the routine group received the conventional treatment only. The clini-cal and blood test indexes of the two groups were compared. [Results] There were no significant differences in operation time, total bloodloss and incidence of adverse events between the two groups (P＞0.05). The TEAS group proved significantly superior to the routine group interm of dynamic pain VAS score at 7 days [(4.5±1.4) vs (5.1±1.3), P=0.018] and 14 days [(2.4±1.1) vs (3.9±1.5), P＜0.001], static pain VASscore at 7 days [(2.0±1.1) vs (2.6±1.5), P=0.043] and 14 days after surgery [(1.0±0.9) vs (1.4±1.1), P=0.033]. The TEAS group was also sig-nificantly better than the routine group regarding suprapatellar 10 cm circumference [(45.3±2.9) cm vs (48.1±4.3) cm, P=0.038] and theknee ROM [(122.3±9.3)° vs (115.6±7.4)°, P＜0.001] 14 days postoperatively. With respect of blood test, the TEAS group was also significant-ly superior to the routine group in Fib [(3.8±0.9) s vs (4.3±1.0) s, P=0.027], D-D [(7.1±15.8) mg/L vs (14.7±23.1) mg/L, P=0.048] and PT[(11.5±0.6) s vs (11.2±0.6) s, P=0.026] 7 days postoperatively. [Conclusion] TEAS might effectively reduce the early reaction after TKAand promote postoperative recovery.

Key words:knee osteoarthritis; total knee arthroplasty; postoperative pain; percutaneous acupoint electrical stimulation; coagulationfunction