摘要
目的探讨快速康复外科(fast-track surgery,FTS)在膝关节置换术(total knee arthroplasty,TKA)后功能锻炼的应用效果。方法选择2015年4月1日-2016年7月1日于我院骨科行膝关节置换术的病例49例(66膝),随机分为快速康复组(以下简称F组,25例33膝)和传统康复组(以下简称T组,24例33膝)。两组患者性别、年龄、患侧、美国特种外科医院(hospital for special surgery,HSS)评分、膝关节主动活动度术前差异均无统计学意义(P>0.05)。膝关节置换术后,快速康复组在快速康复外科理念指导下进行功能锻炼,训练的开始时间较传统康复有所提前,训练的频率和强度明确说明;传统康复组患者按照传统康复理念进行功能锻炼。分别于术后1个月、3个月比较两组膝关节主动活动度、HSS评分。结果膝关节置换术后1个月时,F组膝关节主动活动度为(105.6±8.1)°,高于T组的(94.1±8.5)°(P<0.05),F组HSS评分为69.4±4.1,优于T组的59.2±6.4(P<0.05);术后3个月时,F组的膝关节主动活动度为(116.3±7.2)°,高于T组的(98.5±6.9)°(P<0.05),F组HSS评分为80.6±3.0,优于T组的68.3±4.2(P<0.05)。结论快速康复外科方法应用于膝关节置换术后功能锻炼,有利于患者加快术后康复。
Objective To explore the effect of functional exercise under the guidance of fast-track surgery on the recovery of patients with total knee arthroplasty. Methods A total of 49 patients（66 knees） who underwent total knee arthroplasty from April 1,2015 to July 1,2016 were selected. Patients were randomly divided into two groups,fast-track surgery group（group F,n=25,33knees） and traditional rehabilitation group（group T,n=24,33 knees）. The differences of baseline data between two groups were not significant（P〈0.05） before total knee arthroplasty. After surgery,patients in group F did functional exercise under the guidance of fast-track surgery. Functional exercise in group F was commenced earlier than group T. The frequency and intensity were specified; Patients in group T underwent functional exercise according to traditional rehabilitation theory. Active range of motion of the knee joint and hospital for special surgery（HSS） score were recorded and compared at 1 month and 3 months after operation between 2 groups. Results At 1 month after operation,the difference of active range of motion of knee joint between group F（105.6±8.1）° and group T（94.1±8.5）° was significant（P〈0.05）. The difference of HSS score between group F（69.4±4.1） and group T（59.2±6.4） was significant（P〈0.05）. At 3 months after operation,active range of motion of knee joint in group F（116.3±7.2）° was greater than that of group T（98.5±6.9）°（P〈0.05）. The HSS score of group F（80.6±3.0） was higher than that of group T（68.3±4.2）（P〈0.05）. Conclusion Functional exercise after total knee arthroplasty based on fast-track surgery concept is worthy of clinical application due to the ability to promote recovery after operation.
出处
《解放军医学院学报》
CAS
2017年第4期317-319,349,共4页
Academic Journal of Chinese PLA Medical School
关键词
膝关节置换术
快速康复外科
功能锻炼
total knee arthroplasty
fast-track surgery
functional exercise
