探讨持续冷疗和间歇冷疗两种方式对肱骨干骨折患者术后早期疼痛肿胀的影响。

回顾性分析本科2019年5月至2021年5月收治的肱骨干骨折65例患者，按照不同的冷疗方式分为持续冷疗组（n=33）和间歇冷疗组（n=32）。持续冷疗组采用冰囊持续冷疗法，间歇冷疗组采用冰囊间歇冷疗法。比较两组患者术前1 d、术后1~3 d患肢肿胀程度，术前1 d、术后第1天和第3天的疼痛程度，术后伤口总引流量。

两组患者术前1 d及术后第1天肿胀程度无显著差异，术后第2天及术后第3天，持续冷疗组的肿胀消退情况明显优于间歇冷疗组，差异有统计学意义（P<0.05）；两组患者术前1 d及术后第1天疼痛程度无显著差异，术后第3天持续冷疗组的疼痛缓解明显优于间歇冷疗组，差异有统计学意义（P<0.05）；持续冷疗组的术后伤口引流总量小于间歇冷疗组，差异有统计学意义（P<0.05）。

持续冷疗法较间歇冷疗法能更好地缓解肱骨干骨折患者术后疼痛、肿胀，减少出血量，值得临床推广应用。

Humeral shaft fracture refers to the fracture from 1-2 cm below the humeral surgical neck to 2 cm above the humeral condyle, which is mainly caused by direct, indirect, rotational violence or other factors, requiring effective treatment as soon as possible due to the rich blood vessels near humeral shaft and traumatic reactions, swelling and pain are more obvious once fracture occurs. Postoperative functional rehabilitation is often affected by severe limb pain and swelling, influencing postoperative comfort and surgical satisfaction of patients. How to improve perioperative pain, comfort and quality of life is a clinical issue that orthopedic surgeons are concerned about. Existing studies have shown that cold therapy plays an important role in relieving postoperative pain. Currently, continuous cold therapy, intermittent cold therapy, compression cold therapy, circulation cold therapy and other cold therapy methods have been used in clinical treatment of limb fracture or postoperative detumescence, but there are still differences in the therapeutic effects among different cold therapy methods in different parts.

To investigate the effects of continuous cold therapy and intermittent cold therapy on early postoperative pain and swelling in patients with humeral shaft fractures.

From May 2019 to May 2021, 65 patients with humeral shaft fractures treated in our department were retrospectively analyzed. According to different cold therapy methods, they were divided into continuous cold treatment group (33 cases) and intermittent cold treatment group (32 cases) . The patients in the continuous cold therapy group was treated with ice bag continuous cryotherapy, and the patients in the intermittent cold therapy group was treated with ice bag intermittent cryotherapy. The swelling degree, pain and total drainage volume of the affected limb were compared between the two groups 1 day before operation and on the 1st and 3rd days after operation.

There was no significant difference in the degree of swelling between the two groups 1 day before operation and on the 1st day after operation. On the 2nd day and 3rd day after operation, the swelling regression in the continuous cold treatment group was significantly better than that in the intermittent cold treatment group (P <0.05) ; There was no significant difference in the degree of pain between the two groups1 day before operation and on the 1st day after operation. The pain relief in the continuous cold therapy group on the 3rd day after operation was significantly better than that of the intermittent cold therapy group (P <0.05) . The total amount of postoperative wound drainage in the continuous cold therapy group was less than that in intermittent cold therapy group (P <0.05) .

Compared with intermittent cold therapy, continuous cold therapy can better alleviate the postoperative pain and swelling of patients with humeral shaft fractures and reduce the amount of bleeding. It is worthy of clinical application.