摘要
目的 探究“早期康复方案”在关节镜下半月板术后对膝关节功能早期恢复的影响。方法 回顾性分析2022年1月—2023年1月北部战区总医院骨科诊治的膝关节半月板损伤患者73例,男性66例,女性7例;年龄18~44岁,平均27.2岁。病例均证实存在半月板损伤手术指征,依据术后康复方法的不同分为早期康复组(41例)和常规康复组(32例),早期康复组术后拔除引流管后在常规康复方案的基础上请康复科医师前来会诊指导早期康复治疗及物理治疗和功能锻炼,常规康复组术后住院期间采取常规康复方案。两组患者出院后均前往康复科行3周的康复治疗。观察术后第2、6个月膝关节VAS、肢体对称指数(LSI)、Lysholm评分、国际膝关节文献委员会(IKDC)主观评分、膝关节活动度(ROM)和两组患者住院及康复期间出现的不良反应。结果 两组患者随访6~18个月,平均9.8个月,两组患者术前一般资料比较差异无统计学意义(P>0.05);术后第2个月早期康复组VAS(1.9±0.9)分、LSI(81.4±5.7)%、Lysholm评分(82.1±8.9)分、IKDC评分(80.2±6.6)分、ROM屈(120.7±7.8)°、ROM伸(8.4±2.5)°均优于常规康复组[VAS(2.8±0.9)分、LSI(75.0±7.9)%、Lysholm评分(77.7±5.3)分、IKDC评分(76.5±5.5)分、ROM屈(112.9±6.6)°、ROM伸(12.3±4.1)°],差异有统计学意义(P<0.05);术后第6个月早期康复组LSI(89.5±5.0)%优于常规康复组(86.4±6.9)%,差异有统计学意义(P<0.05)。两组术后不良反应比较差异无统计学意义(P>0.05)。结论 “早期康复方案”有益于关节镜下半月板术后早期膝关节功能、关节ROM的恢复,有助于减少患者术后早期疼痛。
Objective To explore the efficacy of“early rehabilitation program”on the early recovery of knee function after arthroscopic meniscus surgery.Methods From Jan.2022 to Jan.2023,73 cases of knee menis-cus injury diagnosed and treated in the General Hospital of Northern Theater Command were retrospectively select-ed.There were 66 males and 7 females,aged 18-44(mean 27.2)years.All cases were confirmed to have surgical indications of the meniscus injury.According to different postoperative rehabilitation methods,the patients were di-vided into routine and early rehabilitation groups.In the routine rehabilitation group,a routine rehabilitation program was adopted during the postoperative hospitalization period(n=32);while in the early rehabilitation group,rehabil-itation doctors were invited after postoperative extubation to guide and conduct early rehabilitation treatment,physical therapy and functional exercises in addition to the routine rehabilitation program(n=41).After discharge,both groups of patients went to the rehabilitation department for another 3-week rehabilitation treatment.The observation indicators included VAS,limb symmetry index(LSI),Lysholm score,International Knee Documentation Committee(IKDC)subjective score,and range of motion(ROM)at the 2nd and 6th months after surgery and adverse events during hospitalization.Results All the patients were followed up for 6-18(mean 9.8)months.There was no signif-icant difference in preoperative general data between the two groups(P>0.05),and at the 2nd month after surgery,the early rehabilitation group showed much lower VAS(1.9±0.9 vs.2.8±0.9),LSI(81.4%±5.7%vs.75.0%±7.9%),Lysholm score(82.1±8.9 vs.77.7±5.3),IKDC score(80.2±6.6 vs.76.5±5.5),ROM flexion(120.7°±7.8°vs.112.9°±6.6°)and ROM elongation(8.4°±2.5°vs.12.3°±4.1°,all P<0.05);at the 6th month after surgery,the LSI was much higher in the early rehabilitation group(89.5%±5.0%vs.86.4%±6.9%,P<0.05)and other variables revealed no significant difference.The incidence of postoperative adver
作者
杜树远
刘欣伟
李阳
刘桂楠
梁操
李宝
李思桐
刘铭
Du Shuyuan;Liu Xinwei;Li Yang;Liu Guinan;Liang Cao;Li Bao;Li Sitong;Liu Ming(Department of Orthopedics,General Hospital of Northern Theater Command,Shenyang110016,China;Graduate School of China Medical University,Shenyang110122,China;Department of Rehabilitation Medicine,General Hospital of Northern Theater Com-)
出处
《创伤外科杂志》
2024年第7期528-533,共6页
Journal of Traumatic Surgery
基金
辽宁省科学技术计划项目(2022-YGJC-07)。
关键词
膝关节损伤
半月板
关节镜
加速康复外科
Knee joint injury
Meniscus
Arthroscopy
Enhanced recovery after surgery
