低温物理治疗在桡骨远端骨折早期镇痛中的应用

摘要

目的 探讨10%盐水冰袋的低温物理治疗方法在桡骨远端骨折病人早期镇痛、消肿中的应用效果.方法 将2016年3月至2017年3月我科收治的74例桡骨远端骨折病人(男53例,女21例),按照随机数字表法分为两组:对照组(37例)实施常规护理,即伤后72 h内按照急性期处理原则给予患肢局部保护、休息、冰敷、压迫和抬高制动等常规护理;干预组(37例)在常规护理的基础上实施低温物理治疗,即伤后72 h内用自制的10%盐水冰袋间断性加压敷于患肢,30 min/次,每次间隔2 h.比较两组病人镇痛消肿效果.结果 两组病人入院后不同阶段疼痛视觉模拟量表(visual analogue scale,VAS)评分进行比较,干预组均优于对照组,差异均有统计学意义(均P<0.05).干预组的总有效率(94.59%)高于对照组(70.27%),差异有统计学意义(χ2=7.559,P=0.006).对照组有4例(10.81%)病人出现不良反应,干预组有2例(5.41%)病人出现不良反应;两组不良反应率比较,差异无统计学意义(χ2=6.215,P=0.394).病人经对症治疗后,症状均消失.结论 10%盐水冰袋制作简便、温度恒定可控、与体表接触贴服,能更有效地缓解桡骨远端骨折病人早期疼痛肿胀.%Objective To investigate the effect of hypothermic physiotherapy using 10% saline ice pack on relieving early pain and swelling of patients with distal radius fractures. Methods From March 2016 to March 2017, 74 cases of distal radius fractures (53 males and 21 females) were divided into control group and intervention group by random number table. Patients in control group received conventional nursing care. According to the principle of acute phase processing, the injured limbs were given local protection, rest, ice compress, oppression, and raised within 72 h following injury. Patients in intervention group were given hypothermic physiotherapy based on conventional treatment. Within 72 h following injury, the injured limbs were oppressed by man-made 10% saline ice pack for 20 min, every 2 h. Then the effects of analgesic and detumescence were compared between two groups. Results At the different time points after treatment, the visual analogue scale (VAS) scores were significantly lower in the intervention group than that in the control group (P<0.05 for all). The effectiveness of relieving swelling in the intervention group (94.59%) was better than in the control group (70.27%) (χ2=7.559, P=0.006). The adverse events of drugs in the control group and intervention group occurred in 4 cases (10.81%) and 2 cases (5.41%), respectively (χ2=6.215, P=0.394). The symptoms disappeared after symptomatic treatment. Conclusion It is easy to make 10%saline ice bags. 10%saline ice bags have advantages of constant and controllable temperature, close adherence to joint skin, and high compliance. It can relieve early pain and swelling of patients with distal radius fractures more effectively.