Cryotherapy on postoperative rehabilitation of joint arthroplasty
Cryotherapy on postoperative rehabilitation of joint arthroplasty
复制标题
冷冻治疗对关节置换术后康复的影响
DOI：
10.1007/s00167-014-3135-x
复制
发表时间：
2015-11-01
影响因子：
3.8
通讯作者：
Zhao, Jie
中科院分区：
文献类型：
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作者：
Ni, Sheng-Hui;Jiang, Wen-Tong;Zhao, Jie
冷冻疗法对关节置换术后恢复的有效性仍存在争议。本系统评价旨在评估关节置换术后患者冷冻治疗的有效性，对包括科克伦图书馆（2013）、MEDLINE（1950-2013）和Embase（1980-2013）在内的多个数据库进行了全面文献检索。我们寻找随机对照试验，比较关节置换术后接受任何形式冷冻治疗的实验组与任何对照组。主要结局为术后失血量、不良事件和疼痛。使用Revman 5.0进行分析。结果显示为平均差（MD）和标准差或风险差和95%置信区间（CI）。10项试验包括660例全膝关节置换术，3项试验包括122例全髋关节置换术（THA）符合纳入标准。冷冻治疗显著减少失血量（MD = -109.68; 95% CI -210.92至-8.44; P = 0.03）。冷冻治疗不会增加不良反应的风险（n.s.）。冷冻治疗在术后第二天减轻了疼痛（MD = -1.32; 95% CI -2.37至-0.27; P = 0.0003），但在术后第一天和第三天没有减轻疼痛（n.s.）。冷冻疗法在这些选定的患者关节成形术后有效。冷冻治疗对关节置换术后失血的好处是明显的。然而，亚组分析表明冷冻治疗并不能减少THA术后的失血量。冷冻治疗不会增加不良反应的风险。冷冻治疗可以减轻术后第二天的疼痛，但不能减轻术后第一天和第三天的疼痛。II.
The effectiveness of cryotherapy on joint arthroplasty recovery remains controversial. This systematic review was conducted to assess the effectiveness of cryotherapy in patients after joint arthroplasty.Comprehensive literature searches of several databases including Cochrane Library (2013), MEDLINE (1950-2013), and Embase (1980-2013) were performed. We sought randomised controlled trials that compared the experimental group received any form of cryotherapy with any control group after joint arthroplasty. The main outcomes were postoperative blood loss, adverse events, and pain. Analyses were performed with Revman 5.0. Results were shown as mean differences (MD) and standard deviations or as risk difference and 95 % confidence intervals (CIs).Ten trials comprised 660 total knee arthroplastys and three trials comprised 122 total hip arthroplastys (THAs) met the inclusion criteria. Blood loss was significantly decreased by cryotherapy (MD = -109.68; 95 % CI -210.92 to -8.44; P = 0.03). Cryotherapy did not increase the risk of adverse effect (n.s.). Cryotherapy decreased pain at the second day of postoperative (MD = -1.32; 95 % CI -2.37 to -0.27; P = 0.0003), but did not decreased pain at the first and third day of postoperative (n.s.).Cryotherapy appears effective in these selected patients after joint arthroplasty. The benefits of cryotherapy on blood loss after joint arthroplasty were obvious. However, the subgroup analysis indicated that cryotherapy did not decreased blood loss after THA. Cryotherapy did not increase the risk of adverse effect. Cryotherapy decreased pain at the second day of postoperative, but did not decreased pain at the first and third day of postoperative.II.