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[1]杜玉萍,王獻印,陳向軍,等.芒硝外敷減輕全膝關(guān)節(jié)置換術(shù)后早期膝關(guān)節(jié)腫痛的有效性Meta分析[J].中醫(yī)正骨,2022,34(03):32-37.
　DU Yuping,WANG Xianyin,CHEN Xiangjun,et al.Clinical efficacy of external application of mirabilite for relieving early knee swelling and pain after total knee arthroplasty:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(03):32-37.
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芒硝外敷減輕全膝關(guān)節(jié)置換術(shù)后早期膝關(guān)節(jié)腫痛的有效性Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年03期
頁碼:
32-37
欄目:
文獻研究
出版日期:
2022-03-20

文章信息/Info

Title:
Clinical efficacy of external application of mirabilite for relieving early knee swelling and pain after total knee arthroplasty:a meta-analysis
作者:
杜玉萍; 王獻印; 陳向軍; 宋山峰; 王統(tǒng)正; 李百華
(濮陽市中醫(yī)醫(yī)院,河南 濮陽 457003)
Author(s):
DU Yuping; WANG Xianyin; CHEN Xiangjun; SONG Shanfeng; WANG Tongzheng; LI Baihua
Chinese Medicine Hospital of Puyang,Puyang 457003,Henan,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  芒硝;  冷凍療法;  專題Meta分析;  系統(tǒng)評價
Keywords:
arthroplasty; replacement; knee;  natrii sulfas;  cryotherapy;  meta-analysis as topic;  systematic review
摘要:
目的:系統(tǒng)評價芒硝外敷減輕全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)后早期膝關(guān)節(jié)腫痛的有效性。方法:應(yīng)用計算機檢索中國生物醫(yī)學文獻數(shù)據(jù)庫、萬方數(shù)據(jù)庫、中國知網(wǎng)、維普網(wǎng)、Cochrane Library、Web of Science、PubMed、Embase建庫至2021年4月收錄的比較常規(guī)冰敷(對照組)與單獨芒硝外敷或常規(guī)冰敷聯(lián)合芒硝外敷(試驗組)減輕TKA術(shù)后早期膝關(guān)節(jié)腫痛的有效性的隨機對照試驗研究文獻。由2名研究者按照納入、排除標準獨立進行文獻篩選和數(shù)據(jù)提取,采用Cochrane偏倚風險評估工具對納入的文獻進行質(zhì)量評價,采用Cochrane協(xié)作網(wǎng)提供的RevMan5.4軟件進行Meta分析,采用GRADE profiler3.6軟件進行證據(jù)質(zhì)量評價。結(jié)果:共檢索出57篇文獻,經(jīng)逐層篩選,最終納入8篇文獻,均為中文文獻。Meta分析結(jié)果顯示,2組患者術(shù)后48 h、72 h膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分的組間差異均無統(tǒng)計學意義[術(shù)后48 h:I2=0%,P=0.900; MD=-0.18,95%CI(-0.48,0.12),P=0.230。術(shù)后72 h:I2=0%,P=1.000,MD=-0.07,95%CI(-0.24,0.10),P=0.410],試驗組術(shù)后7 d膝關(guān)節(jié)疼痛VAS評分低于對照組[I2=91%,P=0.000; MD=-0.61,95%CI(-0.93,-0.28),P=0.000]; 試驗組術(shù)后3 d、7 d膝關(guān)節(jié)上方10 cm處周徑均小于對照組[術(shù)后3 d:I2=79%,P=0.000; MD=-1.41,95%CI(-2.55,-0.27),P=0.020。術(shù)后7 d:I2=0%,P=0.870; MD=-0.89,95%CI(-1.68,-0.09),P=0.030]; 2組患者術(shù)后48 h引流量比較,差異無統(tǒng)計學意義[I2=88%,P=0.003; MD=-82.88,95%CI(-171.30,5.55),P=0.070]; 共2項研究涉及術(shù)后隱性失血量的比較,結(jié)果均顯示術(shù)后7 d時試驗組術(shù)后隱性失血量小于對照組,但其中1項研究的結(jié)果顯示術(shù)后3 d、5 d時2組患者術(shù)后隱性失血量的差異均無統(tǒng)計學意義。證據(jù)質(zhì)量評價結(jié)果顯示,膝關(guān)節(jié)疼痛VAS評分、膝關(guān)節(jié)腫脹情況的證據(jù)質(zhì)量為中,隱性失血量、術(shù)后48 h引流量的證據(jù)質(zhì)量為極低。結(jié)論:在TKA術(shù)后應(yīng)用芒硝外敷,可以有效減輕術(shù)后早期膝關(guān)節(jié)腫痛,其療效優(yōu)于常規(guī)冰敷。
Abstract:
Objective:To systematically review the clinical efficacy of external application of mirabilite for relieving early knee swelling and pain after total knee arthroplasty(TKA).Methods:All the randomized controlled trial(RCT)articles about the clinical efficacy of conventional ice compress(control group)versus external application of mirabilite alone or conventional ice compress combined with external application of mirabilite(experimental group)for relieving early knee swelling and pain after TKA included from database establishing to April 2021 were retrieved from Chinese Biomedical Literature Database,Wanfang Database,China National Knowledge Internet,Vip Database,Cochrane Library,Web of Science,PubMed and Embase through computer.The articles were screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria.The methodological quality of research in the articles was evaluated by using Cochrane bias risk assessment tools and the quality of evidences was evaluated by using GRADE profiler3.6 software,and a Meta-analysis was conducted by using RevMan5.4 software provided by Cochrane Collaboration.Results:Fifty-seven articles were searched out.After screening,8 Chinese articles were included in the final analysis.The results of Meta-analysis revealed that there was no statistical difference in knee pain visual analogue scale(VAS)score between the 2 groups at postoperative hour 48 and 72(postoperative hour 48:I2=0%,P=0.900; MD=-0.18,95%CI(-0.48,0.12),P=0.230.postoperative hour 72:I2=0%,P=1.000,MD=-0.07,95%CI(-0.24,0.10),P=0.410).The knee pain VAS score was lower in experimental group compared to control group at postoperative day 7(I2=91%,P=0.000; MD=-0.61,95%CI(-0.93,-0.28),P=0.000).The perimeter of leg at 10 cm above the knee was smaller in experimental group compared to control group at postoperative day 3 and 7(postoperative day 3:I2=79%,P=0.000; MD=-1.41,95%CI(-2.55,-0.27),P=0.020.postoperative day 7:I2=0%,P=0.870; MD=-0.89,95%CI(-1.68,-0.09),P=0.030).There was no statistical difference in postoperative 48-hour drainage volume between the 2 groups(I2=88%,P=0.003; MD=-82.88,95%CI(-171.30,5.55),P=0.070).The postoperative hidden blood loss was compared between the 2 groups in 2 researchs,and the results showed that the postoperative hidden blood loss was less in experimental group compared to control group at postoperative day 7,while the results of one research showed that there was no statistical difference in postoperative hidden blood loss between the 2 groups at postoperative day 3 and 5.The results of evidence quality evaluation showed that the evidence quality of knee pain VAS score and knee swelling was medium,while an extremely poor evidence quality was found in hidden blood loss and postoperative 48-hour drainage volume.Conclusion:External application of mirabilite can effectively relieve early knee swelling and pain after TKA,and its clinical efficacy is better than that of conventional ice compress.

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(收稿日期:2021-05-15 本文編輯:時紅磊)

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通訊作者:李百華 E-mail:[email protected]
更新日期/Last Update: 1900-01-01