Albrecht S, le Blond R, Köhler V, Cordis R, Gill C, Kleihues H, Schlüter S, Noack W
Abteilung für Orthopädie, Ev. Waldkrankenhaus Spandau, Akademisches Lehrkrankenhaus, Klinikum Rudolf Virchow Medizinische Fakultät, Humboldt-Universität Berlin.
Z Orthop Ihre Grenzgeb. 1997 Jan-Feb;135(1):45-51. doi: 10.1055/s-2008-1039554.
The application of crushed ice or hydrogenated silicate, a micro-crystalline substitute has been used as a method to treat posttraumatic and postoperative irritations of the locomotor system for a long time. Closed systems using pumps can be viewed as further development as they enable continuous, water-free cooling of operating areas. The analgetic effect of postoperative cold therapy was evaluated in a prospective clinical trial, including 312 patients after total knee or hip arthroplasty. Conventional cold packs, consisting of microcrystalline silicate were compared to a continuous applicable closed system. Continuous cryotherapy resulted in a depression of skin temperature to 12 degrees C, whereas intermittent cooling only caused a mean temperature decrease of 1 degree C. Clinically continuous cold application leads to a more than 50% decrease of analgetic demands in both, systemic and regional application (p < 0.001). This observation was found in a significant correlation with patient's pain sensation as well as primary range of motion. Intermittent cryotherapy was found to be ineffective in postoperative pain relieve in hip- and adequate in knee arthroplasty patients. We could not report an influence on postoperative blood loss, as discussed in previous reports.
长期以来，碎冰或氢化硅酸盐（一种微晶替代物）的应用一直被用作治疗运动系统创伤后和术后刺激的方法。使用泵的封闭系统可被视为进一步的发展，因为它们能够对手术区域进行连续、无水冷却。在一项前瞻性临床试验中，对312例全膝关节或髋关节置换术后的患者评估了术后冷疗的镇痛效果。将由微晶硅酸盐组成的传统冷敷袋与可连续应用的封闭系统进行了比较。连续冷冻疗法使皮肤温度降至12摄氏度，而间歇性冷却仅使平均温度降低1摄氏度。临床上，无论是全身应用还是局部应用，连续冷敷均可使镇痛需求降低50%以上（p<0.001）。这一观察结果与患者的疼痛感觉以及初始活动范围显著相关。发现间歇性冷冻疗法对髋关节置换术后疼痛缓解无效，而对膝关节置换术患者则足够有效。正如先前报告中所讨论的，我们无法报告其对术后失血的影响。
