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[冷冻疗法。冰敷期间关节温度的变化——实际应用的基础]

[Cryotherapy. Behavior of joint temperature during ice application-- a basis for practical use].

作者信息

Kern H, Fessl L, Trnavsky G, Hertz H

出版信息

Wien Klin Wochenschr. 1984 Nov 23;96(22):832-7.

PMID:6528612
Abstract

Changes of intraarticular temperature were measured in ten young animals during long-term cryotherapy. The use of cold packs of -23 degrees C and an application time of 30 minutes resulted in a decrease of intraarticular temperature of means = 6.56 +/- 1.04 degrees C. The original temperature was reached again after an average of 215 minutes. With cryotherapy there is an initial reflex increase in temperature is the primary object of therapy, all movements commencement of application. Since movements of a joint result in the mixing of synovia of various temperatures, we recommend the following procedures in cryotherapy: 1. during the application of cold (cooling phase) the patient is ask to move his joint from time to time, in order to attain a faster and more effective decrease in temperature in the joint. 2. But in this cases, in which an intraarticular decrease in temperature is the primary object of therapy, all movements should be avoided during the phase of rewarming. The effect of long-term cryotherapy (Kern, 1980) is a decrease in temperature of sufficient magnitude and duration resulting in a reduction of joint metabolism, thereby of the activity of cartilage degrading enzymes. Accordingly, long-term cryotherapy can be recommended using cold packs of -20 to -23 degrees C for 30 minutes every 5 to 6 hours in acute rheumatic arthritis, posttraumatic oedema and in the acute therapy of sports injuries. A thin towel or blotting tissue is used to avoid local freezing. Slight exercise during the cooling phase can improve the results of cryotherapy.

摘要

在长期冷冻疗法期间,对十只幼龄动物的关节内温度变化进行了测量。使用-23℃的冷敷袋,敷用时间为30分钟,导致关节内温度平均下降6.56±1.04℃。平均215分钟后温度又恢复到初始温度。冷冻疗法开始时会有一个初始的温度反射性升高,而治疗的主要目的是在敷用开始后所有动作过程中降低温度。由于关节活动会导致不同温度的滑液混合,我们在冷冻疗法中推荐以下步骤:1. 在冷敷(降温阶段)时,要求患者不时活动关节,以便在关节内更快、更有效地降低温度。2. 但是,在以关节内温度降低为主要治疗目的的情况下,在复温阶段应避免所有活动。长期冷冻疗法(克恩,1980年)的效果是温度下降到足够的幅度和持续时间,从而导致关节代谢降低,进而降低软骨降解酶的活性。因此,对于急性风湿性关节炎、创伤后水肿和运动损伤的急性治疗,建议使用-20至-23℃的冷敷袋,每5至6小时冷敷30分钟。使用薄毛巾或吸水纸巾以避免局部冻伤。在降温阶段进行轻微运动可改善冷冻疗法的效果。

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