| 王柱,扈盛,夏渊,代菁,冯常武.徒手淋巴引流对全膝关节置换术后康复疗效的Meta分析[J].中国康复,2022,37(8):493-498 |
| 徒手淋巴引流对全膝关节置换术后康复疗效的Meta分析 |
| Effects of manual lymphatic drainage after total knee arthroplasty: a Meta-analysis |
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| DOI： |
| 中文关键词: 徒手淋巴引流 全膝关节置换术 meta分析 疼痛 肿胀 |
| 英文关键词: Manual lymphatic drainage Total knee arthroplasty Meta-analysis Pain Swelling |
| 基金项目:国家重点研发计划基金（2019YFF0301703） |
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| 中文摘要: |
| 目的：探讨徒手淋巴引流（MLD）对全膝关节置换术（TKA）后疼痛、肿胀和关节活动功能障碍的治疗效果。方法：检索PubMed、Embase、Web of science、Cochrane Library、Scopus、CNKI、万方数据、VIP、CBM等数据库，筛选出建库至2021年12月发表的关于MLD对TKA术后的随机对照实验（RCT）。由 2 位评审员对纳入研究进行风险质量评估，使用Review manager 5.3进行统计分析。结果：最终纳入7项RCT，共396名患者。结果显示，MLD在改善疼痛［WMD=-0.36，95%CI：-0.58～-0.13，P=0.002］和大腿周径［WMD=-1.25，95%CI：-1.99～-0.50，P=0.001］上差异具有统计学意义（P<0.05）；但在改善膝关节周径 ［WMD=-0.24, 95%CI:-1.30~ 0.83, P=0.66］、小腿周径［WMD=-0.22, 95%CI: -0.86 ~ 0.42, P=0.51］和膝关节被动屈曲关节活动度（PROM）［WMD=1.96, 95%CI:-1.31~ 5.24, P=0.24］上差异无统计学意义。结论：MLD在降低TKA术后的疼痛和大腿肿胀上较常规治疗更有优势，在膝关节肿胀、小腿肿胀以及膝关节屈曲活动度方面则可能存在辅助治疗作用，但仍需更多高质量、大样本RCT来验证。 |
| 英文摘要: |
| Objective: To investigate the effect of manual lymphatic drainage (MLD) on pain, swelling and joint dysfunction after total knee arthroplasty (TKA). Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, Scopus, Wanfang Database, VIP and CBM were searched until December 2021 and randomized controlled trials (RCT) on MLD after TKA were selected. The included studies were assessed for risk quality using the Cochrane Manual 5.1.0 by two reviewers and analyzed statistically using Review Manager 5.3 after data extraction. Results: A total of 430 patients were included in 7 RCT. Meta-analysis showed that MLD reduced pain ［WMD=-0.36, 95%CI: -0.58 -0.13, P=0.002］ and thigh circumference ［WMD=-1.25, 95%CI: -1.99 -0.50, P=0.001］ after TKA, and the difference was statistically significant (P<0.05). However, in the improvement of knee circumference ［WMD=-0.24, 95%CI: -1.30 -0.83, P=0.66］, calf circumference ［WMD=-0.22, 95%CI: -0.86 -0.42, P=0.51］, knee flexion passive range of motion (PROM) ［WMD=1.96, 95%CI: -1.31-5.24, P=0.24］, there was no significant difference. Conclusion: Compared with conventional treatment, MLD may have an advantage on the pain and thigh swelling after TKA surgery. But in terms of knee swelling, calf swelling and knee flexion mobility, the adjuvant treatment may exist. This conclusion still needs more high quality and large sample RCT to further verify. |
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