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[1]張祿鍇,馬劍雄,匡明杰,等.全膝關節(jié)置換術中膝關節(jié)周圍注射藥物鎮(zhèn)痛的有效性和安全性Meta分析[J].中醫(yī)正骨,2017,29(08):42-47.
　ZHANG Lukai,MA Jianxiong,KUANG Mingjie,et al.Clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(08):42-47.
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全膝關節(jié)置換術中膝關節(jié)周圍注射藥物鎮(zhèn)痛的有效性和安全性Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數:
2017年08期
頁碼:
42-47
欄目:
文獻研究
出版日期:
2017-08-20

文章信息/Info

Title:
Clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty:a meta analysis
作者:
張祿鍇; 馬劍雄; 匡明杰; 趙杰; 馬信龍
天津市天津醫(yī)院,天津 300211
Author(s):
ZHANG Lukai; MA Jianxiong; KUANG Mingjie; ZHAO Jie; MA Xinlong
Tianjin Hospital,Tianjin 300211,China
關鍵詞:
關鍵詞 關節(jié)成形術; 置換; 膝;  Meta分析;  系統(tǒng)評價;  麻醉; 局部
Keywords:
Key words arthroplasty; replacement; knee;  Meta-analysis;  systematic review;  anesthesia; infiltration
摘要:
目的:系統(tǒng)評價全膝關節(jié)置換術(total knee arthroplasty,TKA)中膝關節(jié)周圍注射藥物鎮(zhèn)痛的有效性和安全性。方法:應用計算機檢索Cochrane Library、PubMed、Embase、CNKI、CBM、WanFang Data、VIP建庫至2017年3月29日國內外公開發(fā)表的所有TKA術中膝關節(jié)周圍注射藥物(注射組)與未注射藥物(未注射組)鎮(zhèn)痛的隨機對照研究文獻。由2位研究人員獨立對檢索到的文獻進行篩選與質量評價,采用Revman5.3軟件進行Meta分析。結果:共檢索出281篇文獻,經逐層篩選最終納入10篇文獻,中文文獻5篇、英文文獻5篇。共涉及700例患者,注射組349例、未注射組351例。Meta分析結果顯示,注射組術后制動狀態(tài)疼痛視覺模擬評分和運動狀態(tài)疼痛視覺模擬評分均低于未注射組[WMD=-0.78,95%CI(-1.06,-0.50); WMD=-1.36,95%CI(-1.66,-1.07)]; 注射組術后3 d時的膝關節(jié)活動度大于未注射組[WMD=5.84,95%CI(0.47,11.21)]; 注射組患者術后達到屈膝90°和伸直膝關節(jié)所用時間均比未注射組少[WMD=-2.92,95%CI(-4.96,-0.88); WMD=-19.77,95%CI(-24.89,-14.64)]; 注射組術后惡心、嘔吐的發(fā)生率低于未注射組[RR=0.56,95%CI(0.35,0.87)]; 2組術后深靜脈血栓發(fā)生率和切口感染發(fā)生率比較,組間差異均無統(tǒng)計學意義[RR=0.89,95%CI(0.37,2.16); RR=1.00,95%CI(0.38,2.61)]。結論:TKA術中膝關節(jié)周圍注射鎮(zhèn)痛藥物能有效緩解疼痛、促進膝關節(jié)功能恢復,而且安全性較高。
Abstract:
ABSTRACT Objective:To systematically review the clinical efficacy and safety of analgesia by peri-knee drug injection in total knee arthroplasty(TKA).Methods:All the randomized controlled trial(RCT)articles about analgesia with peri-knee drug injection(injection group)and without peri-knee drug injection(non-injection group)in TKA that published at home and abroad included from database establishing to March 29,2017 were retrieved from Cochrane Library,Pubmed,Embase,China national knowledge internet,CBM,WanFang Database and VIP Database through computer.The acquired articles were screened and the quality of research in the articles was evaluated independently by two researchers,and a Meta-analysis was conducted by using Revman 5.3 software.Results:Two hundred and eighty-one articles were searched out.After screening,10 articles(5 Chinese articles and 5 English articles)were included in the final analysis,349 patients in injection group and 351 in non-injection group.The result of Meta-analysis demonstrated that(1)the pain visual analogue scale(VAS)scores in braking condition and motion condition were lower in injection group compared to non-injection group respectively after TKA[WMD=-0.78,95%CI(-1.06,-0.50); WMD=-1.36,95%CI(-1.66,-1.07)];(2)the knee range of motion were greater in injection group compared to non-injection group at 3 days after TKA[WMD=5.84,95%CI(0.47,11.21)];(3)the time spent in bending knee to a angle of 90 degrees and in straightening knee were less in injection group compared to non-injection group after TKA[WMD=-2.92,95%CI(-4.96,-0.88); WMD=-19.77,95%CI(-24.89,-14.64)];(4)the incidences of nausea and vomiting were lower in injection group compared to non-injection group after TKA[RR=0.56,95%CI(0.35,0.87)]; and(5)there was no statistical difference in the incidences of deep venous thrombosis and incisional wound infection between the 2 groups after TKA[RR=0.89,95%CI(0.37,2.16); RR=1.00,95%CI(0.38,2.61)].Conclusion:Analgesia by peri-knee drug injection can effectively alleviate knee pain and promote knee functional recovery after TKA,meanwhile it has high safty.

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備注/Memo

備注/Memo:
通訊作者:馬信龍 E-mail:[email protected] 第一作者為天津中醫(yī)藥大學2016級碩士研究生
更新日期/Last Update: 2017-12-29