文章摘要
张莺,陈红,江海艳,等.不同温度灌注液在肩关节镜手术中的应用及效果分析.骨科,2021,12(5): 467-470.
不同温度灌注液在肩关节镜手术中的应用及效果分析
Application and Effectiveness of Perfusion Fluid with Different Temperature in Shoulder Arthroscopy
投稿时间:2021-03-08  
DOI:10.3969/j.issn.1674-8573.2021.05.015
中文关键词: 肩关节镜  灌注液温度  肿胀  疼痛  护理
英文关键词: Shoulder arthroscopy  Perfusion fluid temperature  Swelling  Pain  Nursing
基金项目:武汉市同济医院基金资助项目(2021D17)
作者单位E-mail
张莺 华中科技大学同济医学院附属同济医院手术室武汉 430030  
陈红 华中科技大学同济医学院附属同济医院手术室武汉 430030 hopn1213@sina.com 
江海艳 华中科技大学同济医学院附属同济医院手术室武汉 430030  
钟浩 华中科技大学同济医学院附属同济医院手术室武汉 430030  
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中文摘要:
      目的 探讨不同温度的灌注液对肩关节镜手术病人术后肿胀、疼痛及肩关节功能的影响。方法 选取我院2019年1月至2020年1月行肩关节镜择期手术的病人200例,采用随机数字表法将病人分为观察组和对照组,每组各100例。观察组病人采用37 ℃灌注液进行术中灌注,对照组病人采用22 ℃~24 ℃的常温灌注液。观察两组病人低体温及寒战发生情况;测量两组病人术前、术后即刻、术后24 h的臂围和肩周径,并计算术后臂围和肩周径与术前差值;应用疼痛视觉模拟量表(visual analogue scale,VAS)评估病人术前、术后24 h和48 h的疼痛情况;采用美国肩肘外科协会(American Society of Shoulder and Elbow Surgery,ASES)评分评估病人术后3个月和6个月肩关节功能恢复情况。结果 观察组发生低体温5例(5%)及寒战2例(2%),明显低于对照组的11例(11%)和4例(4%)。观察组术后即刻、术后24 h与术前臂围及肩周径的差值较对照明显缩小,差异均有统计学意义(P均<0.05)。观察组术后24 h和48 h VAS评分较对照组改善明显,差异均有统计学意义(P均<0.05)。两组术后3个月和6个月ASES评分的差异均无统计学意义(P均>0.05)。结论 肩关节镜手术中采用37 ℃恒温灌注液,能降低术中低体温及寒战的发生率,减轻病人术后关节肿胀和疼痛,有利于病人术后的快速康复,在临床中有推广价值。
英文摘要:
      Objective To investigate the effectiveness of perfusion fluid with different temperatures for postoperative swelling, pain and shoulder function in patients undergoing shoulder arthroscopy. Methods Totally, 200 patients undergoing shoulder arthroscopy in our hospital from January 2019 to January 2020 were enrolled in this study and randomly divided into observation group (100 cases) and control group (100 cases) with random number table. In the observation group, 37℃ fluid was used for intraoperative lavage, and the control group was treated with room temperature lavage fluid about 22℃-24℃. The occurrence of hypothermia and shivering in the two groups was observed. The arm circumference and shoulder circumference of the two groups were measured before operation, immediately after operation and 24 h after operation, and the difference between arm circumference and shoulder circumference was calculated. Visual analogue scale (VAS) was applied to assess the pain levels before operation, 24 h and 48 h after operation. The American Society of Shoulder and Elbow Surgery (ASES) scores were used to evaluate the recovery of shoulder function at 3rd and 6th month after operation. Results Hypothermia occurred in 5 cases (5%) and shivering in 2 cases (2%) in the observation group, which was significantly less than 11 cases (11%) and 4 cases (4%) respectively in the control group. The difference of arm circumference and shoulder circumference between immediately after operation and 24 h after surgery vs. preoperation in the observation group was significantly lower than that in the control group (all P<0.05). The VAS scores at 24 h and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The ASES scores at 3rd and 6th month after the operation had no statistically significant difference between two groups (P>0.05). Conclusion 37 ℃ constant temperature perfusion in shoulder arthroscopy can reduce the incidence of hypothermia and shivering during operation, alleviated the shoulder joint swelling and pain after operation, and contribute to rapid recovery, which could be promoted in clinical practice.
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