不同时间点冰袋冷敷对踝关节骨折合并有软组织损伤患者术后肿胀与疼痛的影响

摘要

Objective To investigate the influence of different time points of ice bag cold compress on swelling and pain in patients with ankle fracture combined with soft tissue injuries .Methods A retrospective anal-ysis method was carried out on 171 patients with ankle fracture combined with soft tissue injuries in our hospital from Oct.2014 to Mar.2016.There were 105 males and 66 females with an average age of 43.1 (22-71) years.Fifteen cases were injured from high falling ,42 were from road traffic accidents ,64 were from falling and 50 were from sports injury.They were divided into 4 groups according to the starting time point they treated with ice bag cold compress after injury .The state of swelling and pain were compared among the 4 groups ( group A was within 6 h after injury , group B was 7-12 h after injury ,group C was 13-18 h after injury and group D was 19-24 h after injury ) .Ice bag was packaged around the swelling site and changed every 2h.The skin was observed every ten min in case of cold injury .VAS score and swelling degree were compared . Results Patients in group A showed the highest inhibitive effect on swelling and pain within 6-24 h after injury.Patients in group B showed the highest inhibitive effect on swelling and pain within 3-36 h after injury .Patients in group C showed the highest inhibitive effect on swelling and pain within 3-6 h and 0-3 h after injury.Patients in group D showed no improvement of swelling and pain comparing with pre-treatment.Conclusion Ice bag cold compress in treating patients with ankle fracture combined with soft tis-sue injuries can help control the trauma and inflammation,and help reduce the pain of patients and improve the clinical condition of patients.%目的 观察不同时间点使用冰袋冷敷对踝关节骨折合并软组织损伤的患者术后肿胀与疼痛的影响.方法 回顾性分析2014年10月—2016年3月陕西中医药大学第二附属医院收治的171例踝关节骨折合并软组织损伤患者的临床资料,其中男性105例,女性66例;年龄22~71岁,平均43.1岁;高处坠落伤15例,道路交通伤42例,摔伤64例,运动损伤50例.按照患者受伤后至冷敷的时间分为A、B、C、D组,分别在创伤后6h内、7~12h、13~18h、19~24h开始接受冰袋冷敷.患者采用自制冰袋包裹于肿胀明显处,每2h更换1次冰袋,每隔10min观察患者皮肤,以防冻伤.对比伤后不同时间冰敷后四组患者的踝关节肿胀值与疼痛评分.结果 A、B、C组患者分别在冰敷后6~24h、3~36h、3~6h消肿、镇痛效果最好;D组患者冰敷后消肿、镇痛效果不明显.结论 踝关节骨折合并软组织损伤患者创伤后尽早采取冰袋冷敷能有效控制创伤及炎症反应,减少患者痛苦.