中文摘要：

目的用Meta分析的方法研究膝关节周围注射混合镇痛是否辅以糖皮质激素对全膝关节置换（TKA）术后疼痛缓解及功能恢复的疗效分析。方法分别在PUBMED、Springer Link等国内外期刊中检索TKA术中关节周围混合镇痛药物辅以与未辅以糖皮质激素注射的病例对照相关文献,严格按照满足随机对照试验、干预措施等纳入标准和不符合纳入条件的排除标准对文献进行筛选并提取相关资料,通过Review Manager 5.0软件对资料进行Meta分析。结果最终共纳入随机对照试验7篇。资料分析显示,膝关节周围注射混合镇痛药辅以糖皮质激素对TKA后前2 d及1周膝前痛视觉模拟评分（VAS评分）可降低[MD=-0.92,95%CI（-1.70,-0.14）,P=0.02;MD=-0.48,95%CI（-0.73,-0.22）,P〈0.001;MD=-0.31,95%CI（-0.56,-0.05）,P=0.02];直腿抬高试验平均所需时间可缩短[MD=-0.65,95%CI（-0.83,-0.47）,P〈0.001]、平均住院日有缩短[MD=-1.34,95%CI（-1.74,-0.95）,P〈0.001]、降低TKA后吗啡前2 d使用量[MD=-0.70,95%CI（-0.83,-0.57）,P〈0.001;MD=-0.53,95%CI（-0.87,-0.18）,P=0.003]。结论膝关节周围注射混合镇痛药辅以糖皮质激素可以缓解术后早期TKA膝关节疼痛,改善患肢抬高,缩短住院日,降低吗啡使用量,同时也未增加恶心呕吐发生率。

英文摘要：

Objective To investigate the effects of multimodal periarticular injection combining corticosteroid on postoperative pain relief and functional recovery following total knee arthroplasty（ TKA）with Meta analysis. Methods The randomized controlled trials of comparison of multimodal periarticular injection with glucocorticoid in TKA were searched from PUBMED,Springer Link,and other database. The related data were selected in standard of randomized controlled trials,interventions and other inclusion criteria; the literatures did not meet the inclusion criteria were ruled out. The data were analyzed by Manager Review 5. 0. Results Seven randomized controlled trials were eligible for Meta-analysis. The data analysis by visual analogue scale（ VAS） showed that the knee joint injection combined with corticosteroid relieved the pain by the first,two and seven days after TKA[MD =- 0. 92,95% CI（- 1. 70,- 0. 14）,P = 0. 02; MD =- 0. 48,95% CI（- 0. 73,- 0. 22）,P〈0. 001; MD =- 0. 31,95% CI（- 0. 56,- 0. 05）,P = 0. 02]; the average length of hospital stay was improved [MD =- 0. 65,95% CI（- 0. 83,- 0. 47）,P〈0. 001 ],the average length of stay was shortened [MD =- 1. 34,95% CI（- 1. 74,- 0. 95）,P〈0. 001 ],and the amount of morphine used in the first two days was reduced [MD =- 0. 70,95% CI（- 0. 83,- 0. 57）,P〈0. 001; MD =- 0. 53,95% CI（- 0. 87,- 0. 18）,P =0. 003]. Conclusion The knee joint injection combing corticosteroid can relieve early postoperative pain of knee joint,improve the patient＇s limb elevation,shorten the length of hospital stay,and reduce the use of morphine,while the incidence of nausea and vomiting will not increase.