海南医科大学学报

目的:系统评价经皮电刺激改善全膝关节置换术后疼痛与功能的有效性与安全性,为临床应用提供依据。方法:计算机检索在2019年10月之前公开发表在知网、万方、维普、Embase、PubMed、CBM、Cochrane数据库中关于经皮电刺激改善全膝关节置换术后疼痛与功能的随机对照试验。由两位评价者独立提取文献数据,按Cochrane协作网标准评价文献质量,最终采用RevMan5.3软件行Meta分析。结果:符合纳入标准的文献共计7篇,共572例患者,其中试验组236例,对照组236例,比例1∶1;Meta分析结果显示:试验组患者视觉模拟疼痛(VAS)评分[SMD=0.60,95%CI(0.37,0.83),P<0.000 01]、人工膝关节置换术评价表(HSS)评分[SMD=0.94,95%CI(0.43,1.45),P=0.000 3]、不良反应发生率[RR=0.44,95%CI(0.28,0.67),P=0.000 2]方面均显著优于对照组,差异均有统计学意义。结论:经皮电刺激减轻全膝关节置换术后疼痛与改善关节功能方面具有明显的优势,对术后肌力的恢复有很好的帮助,有效提高患者术后生活质量。

Objective: To evaluate the efficacy and safety of percutaneous electrical stimulation in improving the pain and function after total knee arthroplasty.Methods:A computerized search was conducted for randomized controlled trials published in www.cnki, wanfang, VIP, Embase, PubMed, CBM, and Cochrane libraries prior to October 2019 on the improvement of pain and function after total knee replacement by percutaneous electrical stimulation. The two reviewers independently extracted the literature data, evaluated the quality of the literature according to the Cochrane collaborative standards, and finally performed Meta-analysis with RevMan5.3 software.Results:A total of 7 articles met the inclusion criteria, including 572 patients, 236 of which in the experimental group and 236 in the control group, with a ratio of 1:1. Meta-analysis results show that the experimental group patients visual analog pain score [SMD=0.60, 95% CI(0.37,0.83), P<0.000 01], artificial knee joint replacement evaluation score [SMD=0.94, 95% CI(0.43, 1.45), P=0.000 3], the incidence of adverse reactions(RR=0.44, 95% CI(0.28, 0.67), P=0.000 2) were significantly better than that in control group, the differences were statistically significant.Conclusions:Percutaneous electrical stimulation has obvious advantages in alleviating the pain and improving the joint function after total knee arthroplasty. It is helpful for the recovery of postoperative muscle strength and can effectively improve the postoperative quality of life of patients.