摘要
目的：探讨持续被动运动在全膝关节置换术后康复中的作用。方法：全膝关节置换术后患者88例，男58例，女30例。年龄45～72岁，中位数55岁。单侧80例，双侧8例。膝关节骨性关节炎61例，类风湿关节炎23例，创伤性骨关节炎4例。病程3～13个月，中位数8个月。随机分为2组，治疗组42例，对照组46例。治疗组采用持续被动运动联合常规康复方法治疗，对照组采用常规康复方法治疗。分别于治疗前及治疗开始后7 d、14 d评价并比较2组患者膝关节活动度，并采用Judet膝关节功能评价标准评价总体疗效。结果：①膝关节活动度评分。治疗前后不同时间点膝关节活动度评分比较，差异有统计学意义，存在时间效应[治疗组：（12．23±2．27）分，（39．99±3．87）分，（99．24±4．86）分，对照组：（14．29±1．07）分，（30．04±3．96）分，（70．14±4．28）分，F＝16．816，P＝0．039]；2组患者膝关节活动度评分的组间差异总体上有统计学意义（t＝-0．222，P＝0．000），除治疗前以外（t＝0．689，P＝0．084），治疗开始后7 d、14 d治疗组的膝关节活动度评分均高于对照组（t＝-0．763，P＝0．000；t＝-0．148， P＝0．000）；时间因素和分组因素之间存在交互效应（F＝10．254，P＝0．024）。②总体疗效。治疗组优36例、良5例、可1例，对照组优2例、良13例、可17例、差14例。治疗组的总体疗效优于对照组（Z＝-2．670，P＝0．024）。结论：持续被动运动可以有效改善全膝关节置换术后膝关节活动度，促进膝关节功能恢复。
Objective：To study the role of continuous passive motion（CPM）in the postoperative rehabilitation after total knee arthro-plasty（TKA）.Methods：TKA was performed in 88 patients（58 males and 30 females）between the ages of 45 and 72 years（Median =55yrs）.Unilateral TKA was performed in 80 patients and bilateral TKA was performed in 8 patients.Sixty-one patients were diagnosed as kneeosteoarthritis（KOA）,23 patients as rheumatoid arthritis（RA）and 4 patients as traumatic osteoarthritis（TOA）.The course of disease rangedfrom 3 to 1 3 months（Median =8 months）.The patients were randomly divided into 2 groups,42 cases in treatment group,46 cases in con-trol group.The patients in the treatment group were treated with combination therapy of CPMand conventional rehabilitation,while those inthe control group were treated with monotherapy of conventional rehabilitation.The knee range of motion（ROM）was evaluated before treat-ment and at the 7th and 1 4th day after the beginning of the treatment respectively,and the total curative effect was evaluated according toJudet knee function evaluation standard.Results：There was statistical difference in knee ROM scores between different timepoints（treat-ment group：1 2.23 ＋/-2.27,39.99 ＋/-3.87,99.24 ＋/-4.86 points;control group：1 4.29 ＋/-1 .07,30.04 ＋/-3.96,70.1 4 ＋/-4.28points,F =1 6.81 6,P =0.039）,in other words,there was time effect.In general,there was statistical difference in knee ROM scores be-tween the 2 groups（t =-0.222,P =0.000）.The knee ROMscore of the treatment group was higher than that of control group at the 7thand 1 4th day after the beginning of the treatment（t =-0.763,P =0.000;t =-0.1 48,P =0.000）,and there was no statistical differencein knee ROMscores between the two groups before the treatment（t =0.689,P =0.084）.There was interaction between time factor andgrouping factor（F =1 0.254,P =0.024）.Thirty-six patients obtained an excellent result,5 good and 1 fair in the treatment group;while 2patient
出处
《中医正骨》
2014年第9期19-20,24,共3页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
关节成形术
置换
膝
运动疗法
持续被动性
康复
Arthroplasty,replacement,knee
Motion therapy,continuous passive
Rehabilitation
