透明质酸酶（玻璃酸酶）：血肿阻滞中的有益补充？
Hyaluronidase (Hyalase): a useful addition in haematoma block?
作者信息
London N J, Osman F A, Ramagopal K, Journeaux S F
机构信息
Harrogate District Hospital, North Yorkshire, United Kingdom.
出版信息
J Accid Emerg Med. 1996 Sep;13(5):337-8. doi: 10.1136/emj.13.5.337.
OBJECTIVE
To investigate whether hyaluronidase (Hyalase) is a useful and justified addition to haematoma block for pain relief.
METHODS
The study was a randomised double blind trial of 33 consecutive patients attending the accident and emergency department for manipulation of distal radius fracture under haematoma block. Control patients received 1% lignocaine; the treatment group received 1% lignocaine plus 1500 IU hyaluronidase. Manipulation occurred 10 minutes after instituting the block.
RESULTS
16 patients received hyaluronidase, 17 received lignocaine only. One patient with unsuccessful manipulation was excluded. There was no significant difference between the two groups for any of three methods of pain assessment (P > 0.05, Mann Whitney).
CONCLUSIONS
The addition of hyaluronidase does not increase the efficacy of the haematoma block when 10 minutes are allowed to elapse before manipulation, and the increased cost of adding (and risk of allergy) is not justified by any theoretical increased speed of analgesia.
目的
探讨透明质酸酶是否有助于缓解血肿阻滞的疼痛，以及这种添加是否合理。
方法
本研究为一项随机双盲试验，连续33例因桡骨远端骨折在血肿阻滞下进行手法复位的患者前往急诊科就诊。对照组患者接受1%利多卡因；治疗组患者接受1%利多卡因加1500 IU透明质酸酶。在实施阻滞10分钟后进行手法复位。
结果
16例患者接受了透明质酸酶，17例仅接受了利多卡因。1例手法复位未成功的患者被排除。两种方法在三种疼痛评估方式中的任何一种上均无显著差异（P>0.05，曼-惠特尼检验）。
结论
在手法复位前等待10分钟的情况下，添加透明质酸酶不会增加血肿阻滞的疗效，且添加所增加的成本（以及过敏风险）并不能因任何理论上更快的镇痛速度而得到合理证明。
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