切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 691 -701. doi: 10.3877/ cma.j.issn.1674-134X.2024.06.001

专家共识

下肢骨科手术术后肿胀防治专家共识(2024版)
中华医学会骨科学分会关节外科学组   
  • 收稿日期:2024-10-09 出版日期:2024-12-01
  • 基金资助:
    国家自然科学基金青年科学基金项目(82402788)广东省自然科学基金项目(2021A1515012424)广州市科技计划项目(2024A03J1209),(202201010467)

Expert consensus on prevention and treatment of swelling after lower extremity orthopedic surgery (2024 version)

Surgery Group of Chinese Orthopaedic Association Joint   

  • Received:2024-10-09 Published:2024-12-01
引用本文:

中华医学会骨科学分会关节外科学组. 下肢骨科手术术后肿胀防治专家共识(2024版)[J/OL]. 中华关节外科杂志(电子版), 2024, 18(06): 691-701.

Surgery Group of Chinese Orthopaedic Association Joint. Expert consensus on prevention and treatment of swelling after lower extremity orthopedic surgery (2024 version)[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(06): 691-701.

下肢骨科手术术后肿胀是一种常见的并发症,给患者康复和生活质量带来了诸多不便。下肢手术术后肿胀的范围广泛,包括髋、膝关节置换术、创伤手术等各类下肢手术。这些手术都可能导致淋巴液回流障碍或者血管损伤,进而引发肿胀问题。下肢肿胀在围手术期内经常出现,给患者带来疼痛感、功能受限以及增加并发症发生的风险。目前,下肢骨科手术术后肿胀的防治措施主要包括药物治疗、物理疗法和保护性措施。药物治疗方面,利用利尿剂、消炎药物、静脉活性药物等来减轻肿胀现象;物理疗法则包括按摩、冷敷、热敷等,旨在促进淋巴液和血液循环;而保护性措施则强调术后患者的休息、穿戴特定的压力袜等。然而,尽管已有一些术后肿胀防治的方法,但目前仍存在提高和改善的空间。例如,在不同手术类型和个体差异的肿胀防治策略方面缺乏个性化的指导和推荐;同时,对手术过程中可能存在肿胀风险的早期预测和干预也有待改善。因此,迫切需要深入研究和发展针对下肢骨科手术术后肿胀的有效防治策略,以提升患者的康复效果和生活质量。

Postoperative swelling following lower limb orthopedic surgery is a common complication that brings various inconveniences to patients’ rehabilitation and quality of life. The scope of swelling after lower limb surgery is broad, including procedures such as hip and knee joint replacement surgeries, trauma surgeries,and various other lower limb surgeries. These surgeries may potentially result in lymphatic reflux obstruction or vascular damage, consequently triggering swelling issues. Lower limb swelling frequently occurs during the perioperative period, causing patients pain, functional limitations, and an increased risk of complications.Currently, preventive and therapeutic measures for postoperative swelling in lower limb orthopedic surgery mainly involve drug treatment, physical therapy, and protective measures. In terms of drug treatment, diuretics,anti-inflammatory drugs, venotonic medications, etc., are utilized to alleviate edema. Physical therapy includes methods like massage, cold compresses, and hot compresses, with the aim of promoting lymphatic and blood circulation. Protective measures emphasize postoperative patient rest and the use of specific compression stockings. However, despite the existence of some methods for preventing and treating postoperative swelling,there is still room for improvement. For example, personalized guidance and recommendations for swelling prevention and treatment strategies based on different surgical types and individual differences are currently lacking. Additionally, early prediction and intervention for swelling risks during the surgical process also need improvement. Therefore, there is an urgent need for in-depth research and development of effective preventive and therapeutic strategies for postoperative swelling after lower limb orthopedic surgery to enhance patient rehabilitation outcomes and quality of life.

表1 Wright改良证据等级与推荐强度系统
图1 下肢骨科手术术后肿胀鉴别诊断示意图
图2 下肢治疗原则示意图
[1]
Yau LK, Henry FU, Hong CM, et al. Swelling assessment after total knee arthroplasty[J/OL]. J Orthop Surg ( Hong Kong ), 2022, 30 ( 3 ):10225536221127668. DOI: 10.1177/10225536221127668.
[2]
李振怡, 龚洪平, 任妍, 等. 糖尿病足合并下肢水肿的临床诊治进展[J]. 中华糖尿病杂志, 2023, 15( 12 ): 1232-1236.
[3]
Ambrož D. Differential diagnosis of chronic lower limb edema[J].Vnitr Lek, 2022, 68( 3 ): 181-184.
[4]
Saul D, Fischer AC, Lehmann W, et al. Reduction of postoperative swelling with a negative pressure treatment-a prospective study[J/OL]. J Orthop Surg ( Hong Kong ), 2020, 28( 2 ):2309499020929166. DOI: 10.1177/2309499020929166.
[5]
Powell AA, Armstrong MA. Peripheral edema[J]. Am Fam Physician, 1997, 55( 5 ): 1721-1726.
[6]
Ciocon JO, Fernandez BB, Ciocon DG. Leg edema: clinical clues to the differential diagnosis[J]. Geriatrics, 1993, 48( 5 ): 34-40, 45.
[7]
Linitt N. Managing lower limb oedema with compression therapy[J/OL]. Br J Community Nurs, 2015, 20( 6 ): 286, 288. DOI: 10.12968/bjcn.2015.20.6.286.
[8]
Sibbald RG, Elliott JA, Coutts P, et al. Evaluation of longitudinal and tubular compression treatment for lower limb edema[J]. Adv Skin Wound Care, 2020, 33( 12 ): 643-649.
[9]
国家卫生健康委加速康复外科专家委员会骨科专家组, 中国研究型医院学会骨科加速康复专业委员会, 中国康复技术转化及促进会骨科加速康复专业委员会. 骨科加速康复围手术期疼痛管理专家共识[J]. 中华骨与关节外科杂志, 2022, 15( 10 ):739-745.
[10]
Patrignani P, Capone ML, Tacconelli S. Clinical pharmacology of etoricoxib: a novel selective COX2 inhibitor[J]. Expert Opin Pharmacother, 2003, 4( 2 ): 265-284.
[11]
秦渝超, 刘家诚, 黄伟. 老年髋部骨折患者围术期疼痛管理的研究进展[J]. 重庆医学, 2023, 52( 22 ): 3503-3508.
[12]
Hussain R, Tithof J, Wang W, et al. Potentiating glymphatic drainage minimizes post-traumatic cerebral oedema[J]. Nature,2023, 623( 7989 ): 992-1000.
[13]
Tartaglione G, Visconti G, Bartoletti R, et al. Stress lymphoscintigraphy for early detection and management of secondary limb lymphedema[J]. Clin Nucl Med, 2018, 43( 3 ): 155-161.
[14]
Patel H, Skok C, DeMarco A. Peripheral edema: evaluation and management in primary care [J]. Am Fam Physician, 2022,106( 5 ): 557-564.
[15]
Yang L, Wu BY, Wang CF, et al. Indicators and medical tests to identify lower limb swelling causes after total knee arthroplasty: a Delphi study with multidisciplinary experts[J/OL]. J Orthop Surg Res, 2023, 18( 1 ): 573. DOI: 10.1186/s13018-023-03980-6.
[16]
孔为民, 张赫. 妇科肿瘤治疗后下肢淋巴水肿专家共识[J]. 中国临床医生杂志, 2021, 49( 2 ): 149-155.
[17]
Yuksel E, Unver B, Karatosun V. Comparison of kinesio taping and cold therapy in patients with total knee arthroplasty: a randomized controlled trial[J]. Clin Rehabil, 2022, 36( 3 ): 359-368.
[18]
周宗科, 翁习生, 曲铁兵, 等. 中国髋、膝关节置换术加速康复——围术期管理策略专家共识[J]. 中华骨与关节外科杂志,2016, 9( 1 ): 1-9.
[19]
周宗科, 翁习生, 孙天胜, 等. 中国骨科手术加速康复——围术期血液管理专家共识[J]. 中华骨与关节外科杂志, 2017, 10( 1 ):1-7.
[20]
Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the “CEAP” classification[J].Mayo Clin Proc, 1996, 71( 4 ): 338-345.
[21]
Gradalski T. Diuretics combined with compression in resistant limb edema of advanced disease-a case series report[J]. J Pain Symptom Manage, 2018, 55( 4 ): 1179-1183.
[22]
Stücker M, Protz K, Eder S, et al. Diagnosis of leg edema[J/OL].Dermatologie ( Heidelb ), 2023, 74( 3 ): 182-189.
[23]
Bhatt M, Braun C, Patel P, et al. Diagnosis of deep vein thrombosis of the lower extremity: a systematic review and meta-analysis of test accuracy[J]. Blood Adv, 2020, 4( 7 ): 1250-1264.
[24]
Di Nisio M, van Es N, Büller HR. Deep vein thrombosis and pulmonary embolism[J]. Lancet, 2017, 388( 10063 ): 3060-3073.
[25]
Kim KA, Choi SY, Kim R. Endovascular treatment for lower extremity deep vein thrombosis: an overview[J]. Korean J Radiol,2021, 22( 6 ): 931-943.
[26]
Stubbs M, Mouyis M, Thomas M. Deep vein thrombosis[J/OL].BMJ Clin Res, 2018, 360: k351. DOI: 10.1136/bmj.k351.
[27]
Eberhardt RT, Raffetto JD. Chronic venous insufficiency[J].Circulation, 2014, 130( 4 ): 333-346.
[28]
Brouillard P, Witte MH, Erickson RP, et al. Primary lymphoedema[J/OL]. Nat Rev Dis Primers, 2021, 7( 1 ): 77. DOI:10.1038/s41572-021-00309-7.
[29]
Abboud A, Blum J, Butta Z, et al. Lower limb lymphedema: an exploration of various treatment methods[J]. Clin Podiatr Med Surg,2021, 38( 4 ): 589-593.
[30]
Maldonado TS, Rokosh RS, Padberg F, et al. Assessment of quality of life changes in patients with lower extremity lymphedema using an advanced pneumatic compression device at home[J]. J Vasc Surg Venous Lymphat Disord, 2021, 9( 3 ): 745-752.
[31]
Tedeschi R. Biomechanical alterations in lower limb lymphedema:implications for walking ability and rehabilitation[J]. Phlebology,2023, 38( 8 ): 496-502.
[32]
te Slaa A, Dolmans DE, Ho GH, et al. Pathophysiology and treatment of edema following femoropopliteal bypass surgery[J]. Vascular,2012, 20( 6 ): 350-359.
[33]
Rabe E, Carpentier P, Maggioli A. Understanding lower leg volume measurements used in clinical studies focused on venous leg edema[J]. Int Angiol, 2018, 37( 6 ): 437-443.
[34]
Hidding JT, Viehoff PB, Beurskens CH, et al. Measurement properties of instruments for measuring of lymphedema: systematic review[J]. Phys Ther, 2016, 96( 12 ): 1965-1981.
[35]
Markarian B, Toro C, Moreira K, et al. Assessment modalities for lower extremity edema, lymphedema, and lipedema: a scoping review[J/OL]. Cureus, 2024, 16( 3 ): e55906. DOI: 10.7759/cureus.55906.
[36]
Osei DA, Rebehn KA, Boyer MI. Soft-tissue defects after total knee arthroplasty: management and reconstruction[J]. J Am Acad Orthop Surg, 2016, 24( 11 ): 769-779.
[37]
Kirkham AM, Candeliere J, Mai T, et al. Risk factors for surgical site infection after lower limb revascularisation surgery: a systematic review and meta-analysis of prognostic studies[J]. Eur J Vasc Endovasc Surg, 2024, 67( 3 ): 455-467.
[38]
Burnham JP, Kirby JP, Kollef MH. Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review[J].Intensive Care Med, 2016, 42( 12 ): 1899-1911.
[39]
刘书田,赵锋,韩丑萍.循经推拿结合康复锻炼对下肢骨折术后肿胀的影响[J].针灸推拿医学( 英文版 ), 14( 1 ): 46-49.
[40]
王晴, 王宝彦, 季润, 等. 孤立性远端深静脉血栓抗凝治疗的研究进展[J]. 临床药物治疗杂志, 2023, 21( 3 ): 7-11.
[41]
Webb E, Neeman T, Bowden FJ, et al. Compression therapy to prevent recurrent cellulitis of the leg[J]. N Engl J Med, 2020, 383( 7 ):630-639.
[42]
Lieberman JR. Deep vein thrombosis prophylaxis: state of the art[J]. J Arthroplasty, 2018, 33( 10 ): 3107-3108.
[43]
Eddy DM, Adler J, Patterson B, et al. Individualized guidelines: the potential for increasing quality and reducing costs[J]. Ann Intern Med, 2011, 154( 9 ): 627-634.
[44]
Hillegass E, Puthoff M, Frese EM, et al. Role of physical therapists in the management of individuals at risk for or diagnosed with venous thromboembolism: evidence-based clinical practice guideline[J].Phys Ther, 2016, 96( 2 ): 143-166.
[45]
魏婉清, 陈培生, 梁雅茜, 等. 骨科下肢深静脉血栓防治的中西医研究进展[J]. 中医临床研究, 2024( 4 ): 1-5.
[46]
曹晖, 陈亚进, 顾小萍, 等. 中国加速康复外科临床实践指南( 2021版 )[J]. 中国实用外科杂志, 2021, 41( 9 ): 961-992.
[47]
中华医学会骨科学分会创伤骨科学组, 中华医学会骨科学分会外固定与肢体重建学组, 中国医师协会骨科医师分会创伤专家工作委员会, 等. 中国创伤骨科患者围手术期静脉血栓栓塞症预防指南( 2021 )[J]. 中华创伤骨科杂志, 2021, 23( 3 ): 185-192.
[48]
Stein PD, Matta F, Hughes MJ. In-hospital risks and management of deep venous thrombosis according to location of the Thrombus[J].Am J Med, 2021, 134( 7 ): 877-881.
[49]
王深明, 武日东. 下肢深静脉血栓形成治疗指南与实践[J]. 中国实用外科杂志, 2015, 35( 12 ): 1264-1266, 1304.
[50]
中华医学会外科学分会血管外科学组, 中国医师协会血管外科医师分会, 中国医疗保健国际交流促进会血管外科分会, 等. 中国慢性静脉疾病诊断与治疗指南[J]. 中华医学杂志, 2019, 99( 39 ): 3047-3061.
[51]
De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor's choice-European society for vascular surgery ( ESVS ) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs[J]. Eur J Vasc Endovasc Surg, 2022, 63( 2 ): 184-267.
[52]
陈国鑫, 吴洲鹏. 《2022 ESVS下肢慢性静脉疾病管理临床实践指南》解读[J]. 中国普外基础与临床杂志, 2022, 29( 3 ): 308-314.
[53]
Lurie F, Malgor RD, Carman T, et al. The American Venous Forum,American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment[J]. Phlebology, 2022, 37( 4 ): 252-266.
[54]
赵晓东, 吕传柱, 于学忠, 等. 急诊成人细菌性感染诊疗专家共识[J]. 中国急救医学, 2020, 40( 11 ): 1029-1035.
[55]
Duane TM, Huston JM, Collom M, et al. Surgical infection society 2020 updated guidelines on the management of complicated skin and soft tissue infections[J]. Surg Infect, 2021, 22( 4 ): 383-399.
[56]
周武, 曹发奇, 曾睿寅, 等. 创伤骨科患者围术期下肢静脉血栓形成诊断及防治专家共识( 2022年 )[J]. 中华创伤杂志, 2022,38( 1 ): 23-31.
[57]
Gao FQ, Li ZJ, Zhang K, et al. Risk factors for lower limb swelling after primary total knee arthroplasty[J]. Chin Med J, 2011, 124( 23 ):3896-3899.
[58]
Lee Y, Shin YS, Kim HJ, et al. Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: a systematic review on randomized controlled trials[J]. Nurs Open,2023, 10( 9 ): 5989-5998.
[59]
中国健康促进基金会骨病专项基金骨科康复专家委员会.骨科康复中国专家共识[J/OL].中华医学杂志, 2018, 98( 3 ):7. DOI:10.3760/cma.j.issn.0376-2491.2018.03.002.
[60]
Gasparis AP, Kim PS, Dean SM, et al. Diagnostic approach to lower limb edema[J]. Phlebology, 2020, 35( 9 ): 650-655.
[61]
Dresing K, Fischer AC, Lehmann W, et al. Perioperative and posttraumatic anti-edematous decongestive device-based negative pressure treatment for anti-edematous swelling treatment of the lower extremity-a prospective quality study[J]. Int J Burns Trauma,2021, 11( 3 ): 145-155.
[62]
Wang ZR, Ni GX. Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?[J]. World J Clin Cases, 2021, 9( 17 ): 4116-4122.
[63]
Jain N, Avanthika C, Singh A, et al. Deep vein thrombosis in intravenous drug users: an invisible global health burden[J/OL].Cureus, 2021, 13( 10 ): e18457. DOI: 10.7759/cureus.18457.
[64]
周武, 曹发奇, 曾睿寅, 等. 创伤骨科患者围术期下肢静脉血栓形成诊断及防治专家共识( 2022年 )[J]. 中华创伤杂志, 2022,38( 1 ): 23-31.
[65]
Belcaro G , Cesarone MR, de Sanctis MT, et al. Laser doppler and transcutaneous oximetry: modern investigations to assess drug efficacy in chronic venous insufficiency[J]. Int J Microcirc Clin Exp, 1995, 15 ( Suppl 1 ): 45-49.
[66]
Amiel M, Barbe R. Study of the pharmacodynamic activity of daflon 500 Mg[J]. Ann Cardiol Angeiol, 1998, 47( 3 ): 185-188.
[67]
Ibegbuna V, Nicolaides AN, Sowade O, et al. Venous elasticity after treatment with Daflon 500 Mg[J]. Angiology, 1997, 48( 1 ): 45-49.
[68]
付高峰. 益气活血利水法治疗下肢骨折术后早期肿胀的临床疗效观察[J]. 现代诊断与治疗, 2019, 30( 12 ): 1985-1986.
[69]
刘超, 曹玉净, 李扬, 等. 中医内治法治疗下肢骨折术后肿胀的研究进展[J]. 光明中医, 2021, 36( 5 ): 847-850.
[70]
周世霞. 中药治疗下肢骨折术后肿胀的临床疗效观察[J]. 双足与保健, 2019, 28( 8 ): 125-126.
[71]
苏松川, 黄文凭, 黄敏. 五味消毒饮加减治疗下肢骨折术后肿胀临床疗效观察[J]. 北京中医药大学学报( 中医临床版 ), 2013,20( 2 ): 54-55.
[72]
李欣依, 王其美. 加味五味消毒饮治疗热毒炽盛型下肢骨折术后肿胀40例疗效观察[J]. 湖南中医杂志, 2016, 32( 10 ): 87-88.
[73]
毛伟欢, 孙成长, 吴仁文, 等. 五味消毒饮加味在骨折手术后的应用体会[J]. 中国中医急症, 2011, 20( 8 ): 1322.
[74]
张亚丽. 五味消毒饮加减治疗下肢骨折术后肿胀的临床效果评价[J]. 双足与保健, 2019, 28( 11 ): 185-186.
[75]
吴永胜. 五味消毒饮合活血化瘀汤辅助西药治疗下肢骨折术后肿胀患者的效果[J]. 中国民康医学, 2022, 34( 7 ): 123-125, 139.
[76]
周振强, 翁雅芳. 桃红四物汤加减对下肢骨折术后肿胀、炎症反应及血小板活化的影响观察[J]. 中国医学创新, 2022, 19( 30 ):78-82.
[77]
毛华晋, 凃刚城, 邱静, 等. 桃红四物汤对股骨干骨折术后炎性因子和血液流变学的影响[J]. 南京中医药大学学报, 2016, 32( 5 ): 419-421, 497.
[78]
李玉文, 米琨, 朱少廷, 等. 桃红四物汤加二妙散治疗膝关节镜术后早期肿胀的疗效观察[J]. 时珍国医国药, 2016, 27( 9 ):2210-2211.
[79]
徐凯捷, 邵建康. 黄芪消肿汤治疗四肢长骨干骨折术后肿胀伴非感染性发热疗效观察[J]. 现代中西医结合杂志, 2013, 22( 1 ):35-36.
[80]
李晓军, 朱付平. 益气活血方治疗胫腓骨骨折术后早期肿胀45例[J]. 湖南中医杂志, 2015, 31( 7 ): 89, 95.
[81]
王朝君, 王文洁. 三七消肿止痛散外敷联合功能锻炼对下肢骨折患者术后疼痛肿胀程度及膝关节功能的影响[J]. 数理医药学杂志, 2022, 35( 11 ): 1732-1735.
[82]
李国伟, 周瑞华, 李文霞. 冰消散外敷改善下肢骨折患者术后肢体肿胀及疼痛程度临床观察[J]. 光明中医, 2021, 36( 4 ): 519-521.
[83]
陈佳, 曹静, 王朝蓉. 冰硝散外敷治疗下肢深静脉血栓38例[J].现代中医药, 2020, 40( 3 ): 61-64.
[84]
付晓勤, 税毅冬, 刘健佳, 等. 中药熨烫联合高能量半导体激光( HILT )对人工髋关节置换术后肢体肿胀、疼痛的疗效观察[J].四川中医, 2020, 38( 3 ): 141-143.
[85]
郑乙, 邹玉婵, 许学猛. 飞经走气针法对全膝关节置换术后下肢肿胀的疗效观察[J]. 辽宁中医杂志, 2019, 46( 5 ): 1045-1048.
[86]
翁叶虹, 陈红云, 任隐丽, 等. 雷火灸对老年骨折下肢术后肢体肿胀患者疼痛及功能恢复的影响[J]. 吉林中医药, 2023, 43( 1 ):112-115.
[87]
张丽丽. 艾灸疗法对下肢骨折术后疼痛和肿胀的缓解作用研究[J]. 世界最新医学信息文摘, 2019, 19( 76 ): 267, 269.
[88]
赵楠, 史伟伟, 温曼. 耳穴贴压结合中药热奄包干预对下肢骨折患者术后肿胀、疼痛及恢复进程的影响[J]. 包头医学, 2022, 46( 4 ): 52-54.
[89]
徐伟龙, 郝剑, 郑升鹏, 等. 平乐郭氏荣肌揉筋法治疗膝关节置换术后下肢肿胀临床研究[J]. 河南中医, 2022, 42( 5 ): 773-776.
[90]
罗时运, 陈树清, 王少云, 等. 循经推拿结合康复锻炼对下肢骨折术后肿胀的影响分析[J]. 中医临床研究, 2019, 11( 24 ):129-130.
[91]
Klein I, Tidhar D, Kalichman L. Lymphatic treatments after orthopedic surgery or injury: a systematic review[J]. J Bodyw Mov Ther, 2020, 24( 4 ): 109-117.
[92]
Majewski-Schrage T, Snyder K. The effectiveness of manual lymphatic drainage in patients with orthopedic injuries[J]. J Sport Rehabil, 2016, 25( 1 ): 91-97.
[93]
Silverstein DC, Montealegre C, Shofer FS, et al. The association between vascular endothelial growth factor levels and clinically evident peripheral edema in dogs with systemic inflammatory response syndrome[J]. J Vet Emerg Crit Care ( San Antonio ),2009, 19( 5 ): 459-466.
[94]
Mollaelahi F, Shahali S. The effect of modified buerger-Allen exercises on lower extremities edema in late pregnancy: randomized clinical trial[J]. J Obstet Gynaecol India, 2023, 73( 6 ): 488-495.
[95]
Aquil S, Alharbi B, Navaratnam R, et al. Use of a muscle pump activator leads to improved lower limb edema, lower limb blood flow, and urine output compared with standard TED stockings and compression devices following kidney transplant: a randomized controlled trial[J]. Transplant Proc, 2019, 51( 6 ): 1838-1844.
[96]
史占军, 严格, 肖军, 等. 利伐沙班预防全膝关节置换术后静脉血栓栓塞症的临床研究[J/CD]. 中华关节外科杂志( 电子版 ),2014, 8( 6 ): 713-717.
[97]
李世伦, 李一男, 倪其泓, 等. 下肢静脉疾病介入术后的药物治疗方案[J]. 介入放射学杂志, 2023, 32( 7 ): 715-718.
[98]
Eymir M, Unver B, Karatosun V. Relaxation exercise therapy improves pain, muscle strength, and kinesiophobia following total knee arthroplasty in the short term: a randomized controlled trial[J].Knee Surg Sports Traumatol Arthrosc, 2022, 30( 8 ): 2776-2785.
[99]
Munk S, Dalsgaard J, Bjerggaard K, et al. Early recovery after fasttrack Oxford unicompartmental knee arthroplasty. 35 patients with minimal invasive surgery[J]. Acta Orthop, 2012, 83( 1 ): 41-45.
[100]
Gil-González S, Barja-Rodríguez RA, López-Pujol A, et al.Continuous passive motion not affect the knee motion and the surgical wound aspect after total knee arthroplasty[J/OL]. J Orthop Surg Res, 2022, 17( 1 ): 25. DOI: 10.1186/s13018-022-02916-w.
[1] 何敏瑜, 冉素真. 胎儿心内型完全型肺静脉异位引流的产前超声特征总结[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1017-1023.
[2] 陶宏宇, 叶菁菁, 俞劲, 杨秀珍, 钱晶晶, 徐彬, 徐玮泽, 舒强. 右心声学造影在儿童右向左分流相关疾病中的评估价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 959-965.
[3] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[4] 王子杨, 杨文利, 李栋军, 陈伟, 赵琦, 李逸丰, 崔蕊, 沈琳, 刘倩, 魏串串. 高频线阵探头对眼球壁的临床观察[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 580-584.
[5] 曹琮沅, 黄烁金, 何倩婷, 王安训. 平阳霉素复合剂治疗口腔颌面部脉管畸形的有效性和安全性[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 368-374.
[6] 孙莲, 马红萍, 吴文英. 局部进展期甲状腺癌患者外科处理[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 112-114.
[7] 沈柳柳, 周不畏, 王敏, 卢春霞, 邢燕飞. 个体化肺康复及情绪调节对AECOPD并VTE 高危患者生活质量和预后影响分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(06): 971-974.
[8] 于毅, 谢敖文, 刘俊, 王攀, 何德剑, 彭欣然, 何章勇, 何玉成, 李琼, 李洪涛, 王国彦, 周建, 刘升辉, 王永军, 赵春博, 段清垚. 以指捏法切肝为核心技术的全流程管理在严重肝外伤中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 107-112.
[9] 蒙柄成, 朱海, 任洪冰, 毛伟民, 韦德令, 徐邦浩, 王继龙, 金宗睿, 蓝祝晶, 黄柯豫, 卢婷婷, 张灵, 郭雅, 文张. IGF-1 介导FOXO 信号通路在大鼠ALPPS 术后肝再生中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 118-125.
[10] 陈宗杰, 胡添松. 肝外伤破裂患者治疗后胆漏发生影响因素分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 836-840.
[11] 刘卓, 张宗明, 张翀, 刘立民, 赵月, 齐晖. 腹腔镜手术治疗高龄急性梗阻性化脓性胆管炎患者的安全性与术式选择[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 795-800.
[12] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[13] 潘鹏宇, 李根, 刘冬冬, 孔睿, 李侑埕, 李佳朔, 杨新宇, 张文旭, 朱泽超, 田学实, 闻亮, 蒋为, 朱廷准, 冯华, 梁国标. 无创脑水肿监护仪扰动系数对动脉瘤性蛛网膜下腔出血后病情检测能力的临床研究[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(06): 341-345.
[14] 张子豪, 景瑞, 赵浩. 血清NLRP3炎症小体及其下游炎症因子水平与大动脉粥样硬化型脑梗死患者溶栓后出血转化及预后的关系[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(06): 365-372.
[15] 于洁, 金小红, 顾艳楣, 王慧, 葛杨杨, 李燕. 癌症相关静脉血栓栓塞症患者疾病体验与需求的质性研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 739-744.
阅读次数
全文


摘要