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关节镜检查与持续冷冻疗法对膝关节腔内温度的影响

Effect of arthroscopy and continuous cryotherapy on the intra-articular temperature of the knee.

作者信息

Sánchez-Inchausti Guillermo, Vaquero-Martín Javier, Vidal-Fernández Carlos

机构信息

Hospital El Escorial, Madrid, Spain.

出版信息

Arthroscopy. 2005 May;21(5):552-6. doi: 10.1016/j.arthro.2005.01.011.

Abstract

PURPOSE

The purpose of this study was to determine "in vivo" the intra-articular temperature of the knee in baseline situation, to quantify its variation during the arthroscopic surgery and the repercussion on the body temperature, and to quantify the variation of the intra-articular temperature after the application of topic cold postoperatively.

TYPE OF STUDY

Case series. Experimental study in patients who undergo arthroscopic surgery of the knee monitoring their intra-articular temperature.

METHODS

An intra-articular temperature data acquisition system is used in 30 patients who undergo arthroscopic surgery of the knee using saline solution at room temperature and monitoring their body temperature with a rectal temperature probe. In 23 of these patients, after surgery, a plastic bag with 2 kg of ice is applied on the knee, and the variation of the intra-articular temperature is measured for at least 1 hour.

RESULTS

The basal temperature of the knee (32.22 degrees +/- 0.28 degrees C) decreases during the intervention using saline fluid at room temperature to nearly equalize it (24.49 degrees +/- 0.97 degrees C), and it led to a drop of the body temperature of 0.14 degrees +/- 0.04 degrees C. The continuous external application of ice after the arthroscopy produces a drop of the intra-articular temperature directly related to the time, with a magnitude of almost 4 degrees C in the first hour.

CONCLUSIONS

The intra-articular baseline temperature of the knee is significantly lower than that of the body, and the repercussion of its drop during arthroscopic surgery on the body temperature is insignificant. The external application of ice is an effective and sure method to diminish the intra-articular temperature of the knee.

LEVEL OF EVIDENCE

Level IV, case series with no control group.

摘要

目的

本研究旨在“在体”确定膝关节在基线状态下的关节腔内温度,量化关节镜手术期间其变化以及对体温的影响,并量化术后局部应用冷敷后关节腔内温度的变化。

研究类型

病例系列。对接受膝关节镜手术的患者进行关节腔内温度监测的实验性研究。

方法

对30例接受膝关节镜手术的患者使用关节腔内温度数据采集系统,术中使用室温生理盐水,并通过直肠温度探头监测其体温。其中23例患者术后在膝关节上放置一个装有2千克冰的塑料袋,并测量关节腔内温度至少1小时的变化。

结果

膝关节的基础温度(32.22℃±0.28℃)在使用室温生理盐水干预期间下降,几乎趋于平衡(24.49℃±0.97℃),并导致体温下降0.14℃±0.04℃。关节镜检查后持续外用冰袋可使关节腔内温度下降,且与时间直接相关,在第一小时内下降幅度近4℃。

结论

膝关节的关节腔内基线温度显著低于体温,关节镜手术期间其温度下降对体温的影响微不足道。外用冰袋是降低膝关节关节腔内温度的一种有效且可靠的方法。

证据级别

四级,无对照组的病例系列。

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