目的 观察消肿药物结合冰敷、患肢抬高、踝泵的多模式消肿方案在踝关节骨折围手术期的疗效,探讨踝泵影响消肿的因素及护理方法。方法 观察2015年1月—2017年6月我科收治踝关节骨折患者40例,按随机数表法随机分成实验组和对照组,实验组术后每日予以七叶皂苷钠20 mg静滴,术后踝关节冰敷2日,辅助下肢抬高及踝泵护理,对照组仅每日予以七叶皂苷钠20 mg静滴,术后踝关节冰敷2日,辅助下肢抬高。观察患者术后6 h和术后72 h疼痛视觉模拟评分(VAS评分)、踝关节周径变化。结果 术后6 h实验组与对照组(VAS评分)、踝关节周径无明显差异; 术后72 h实验组及对照组较术后6 hVAS评分降低、踝关节周径减小,差异有统计学意义(P<0.05),术后72 h实验组VAS评分、踝关节周径较对照组更小,差异有统计学意义(P<0.05)。结论 使用踝泵可有效缓解患者术后疼痛及肿胀程度,有助于患者的恢复。

Objective To observe the effect of the multi-mode detumescence scheme of antiswelling drug combined with ice compress,elevation of affected limb,and ankle pump in the perioperative period of ankle fracture surgery.Methods A total of 40 cases of ankle fractures treated in the authors’ department were included between January 2015 and June 2017,and randomly divided into experimental group and control group by the table of random numbers.The experimental group was treated with intravenous injection of sodium aescinate at 20 mg daily,postoperative ankle ice twice a day,affected limb raising,and ankle pump nursing.The control group received the same treatment except ankle pump.Visual analogue scale (VAS) score and ankle circumference were observed 6 h and 72 h after surgery.Results There was no significant difference between the experimental group and the control group in VAS score and ankle circumference at postoperative 6 h.The VAS scores and the ankle circumferences of the experimental group and the control group at postoperative 72 h were statistically lower than those at postoperative 6 h (P<0.05),and the two indicators of the experimental group at postoperative 72 h were statistically lower than those of the control group (P<0.05).Conclusion Applying ankle pump can effectively relieve postoperative pain and swelling of patients,which is beneficial to their recovery.