文章摘要
崔俊才,吴鸣,倪朝民,尚希福,张阳.骨科康复一体化模式在全膝关节置换术超早期康复中的应用[J].中国临床保健杂志,2018,21(3):364-369.
骨科康复一体化模式在全膝关节置换术超早期康复中的应用
Application of integrated rehabilitation approach and orthopaedic treatment during perioperative period of total knee arthroplasty
投稿时间:2017-09-26  
DOI:10.3969/J.issn.1672-6790.2018.03.021
中文关键词: 关节成形术,置换,膝  康复  早期医疗干预
英文关键词: Arthroplasty,replacement,knee  Rehabilitation  Early medical intervention 〖FL
基金项目:安徽省公益性技术应用研究联动计划项目(1704f0804005)
作者单位E-mail
崔俊才 中国科学技术大学附属第一医院安徽省立医院康复医学科,合肥 230001 401052317@qq.com 
吴鸣 中国科学技术大学附属第一医院安徽省立医院康复医学科,合肥 230001 ahslyywm@163.com 
倪朝民 中国科学技术大学附属第一医院安徽省立医院康复医学科,合肥 230001  
尚希福 中国科学技术大学附属第一医院安徽省立医院骨科,合肥 230001]  
张阳 中国科学技术大学附属第一医院安徽省立医院康复医学科,合肥 230001  
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中文摘要:
      目的 探讨骨科康复一体化模式在全膝关节置换(TKA)术超早期康复中的应用效果。方法 选取首次单膝TKA手术的100例患者。按照随机数字表法分为治疗组50例,对照组50例。治疗组给予骨科术后常规治疗和超早期系统化康复治疗(术前康复宣教、术后系统化康复治疗及每小时康复管理等综合康复措施)。对照组仅接受骨科术后常规治疗,分别比较术后第1~3天及出院当天两组手术侧膝关节主动屈曲、伸直和关节活动度,静息痛和运动痛,大腿围和小腿围以及术后引流量的情况。结果 术前两组间手术侧膝关节主动屈曲、伸直和关节活动度差异无统计学意义(P>0.05),术后第1~3天及出院当天治疗组手术侧膝关节主动屈曲和关节活动度明显优于对照组,差异有统计学意义(P<0.01),出院当天治疗组手术侧膝关节主动伸直明显优于对照组,差异有统计学意义(P<0.01);术前、术后第1~2天两组间静息痛和运动痛改善程度比较,差异无统计学意义(P>0.05);术后第3天及出院当天治疗组运动痛改善程度明显优于对照组,差异有统计学意义 (P<0.05);术前、术后1~3天及出院当天两组大腿围和小腿围组内健侧和患侧比较,差异无统计学意义(P>0.05)。术后第1天,治疗组引流量明显少于对照组,差异有统计学意义(P<0.01)。结论 骨科康复一体化模式可显著改善TKA术后患者膝关节功能。
英文摘要:
      Objective To observe the application of ointegrated rehabilitation approach and orthopaedic treatment during the perioperative period of total knee arthroplasty (TKA).Methods 100 patients with TKA were divided into the treatment group (n=50) and the control group (n=50),the treatment group was received the routine postoperative treatment and ultra early systematic rehabilitation treatment (preoperative rehabilitation education,postoperative systematic rehabilitation therapy,hourly rehabilitation management and comprehensive rehabilitation measures).The control group was received only routine postoperative treatment.The knee flexion,extension,rest pain,active pain,thigh and calf circumference,and the postoperative drainage were compared between the two groups from 1st to 3rd days after the operation and discharge day.Results There was no significant difference in active flexion,extension and range of motion between the two groups (P>0.05).From the 1st to 3rd day and discharge day,the active flexion and ROM in the treatment group were significantly better than those in the control group(P<0.01) at the discharge day,the active extension in the treatment group were significantly better than those in the control group(P<0.01).There was no significant difference in rest and active pain at the preoperation,1st to 2nd after the operation between the two groups(P>0.05).The improvement of active pain in the treatment group was significantly better than that in the control group at the 3rd and discharge day(P<0.05).There was no significant difference in the healthy and affected side about the thigh and calf circumference at the preoperation,1st to 3rd day and discharge day between the two groups(P>0.05).The drainage flow of treatment group was significantly less than that in the control group at the 1st day after operation (P<0.01).Conclusion Integrated rehabilitation approach and orthopaedic treatment can effectively recover the function after TKA.
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