人工全膝关节置换术后疼痛的诊断和治疗研究进展.pdfVIP

708 Chinese Journal of Reparative and Reconstructive Surgery, June 2010, Vol. 24, No.6 · · 人工全膝关节置换术后疼痛的诊断和治疗研究进展 1 1 2 孙振辉 刘军 王沛 【摘  要】 目的 对人工全膝关节置换（total knee arthroplasty ，TKA ）术后疼痛的原因进行分析，综述其诊断 和治疗方法。  方法 广泛查阅近年国内外TKA 术后疼痛的相关文献，并进行总结与分析。  结果 TKA 术后疼痛 分为关节内和关节外两种因素，系统评估和恰当的影像学、实验室检查有助于明确诊断，针对性的手术可有效缓解疼 痛。  结  论 TKA 术后疼痛原因复杂多样，首先要排除关节内感染，病因明确者可进行相应手术并可获得良好效果。疼 痛原因不明时禁忌盲目翻修，保守治疗可一定程度缓解疼痛。 【关键词】 人工全膝关节置换 疼痛 诊断 治疗 研究进展 中图分类号： R687.4 R684 文献标志码：A RESEARCH DEVELOPMENT OF DIAGNOSIS AND TREATMENT OF PAIN AFTER TOTAL KNEE 1 1 2 1 ARTHROPLASTY/SUN Zhenhui , LIU Jun , WANG Pei . Department of Orthopaedics, Tianjin People’s Hospital, Tianjin, 300121, P.R.China; 2Department of Orthopaedics, General Hospital of Tianjin Medical University. Corresponding author: SUN Zhenhui, E-mail: sunzhenhui123@ 【Abstract 】    Objective To analyze the causes of pain after total knee arthroplasty (TKA), and to review its diagnosis and treatment methods. Methods Domestic and abroad l iterature concerning pain after TKA was extensively reviewed and thoroughly analyzed. Results Pain after TKA was divided into intra-articular and extra-articular factors, systematic assessment, appropriate imaging, and laboratory tests were useful to confirm the diagnosis; targeted surgery could effectively rel ieve the pain. Conclusion The causes of pain after TKA are complex and diverse, the first step is to exclude intra- articular infection, for patients having a clear cause the appropriate surgery is effective. Otherwise revision should be carried out cautiously under condition of