全膝关节置换术后被动与主动活动康复的比较

发布时间：2018-07-28 11:17

【摘要】：[目的]探讨全膝关节置换术后患者对被动与主动活动康复锻炼方式的心理接受程度及心理状态差异,并分析其对功能恢复的影响。[方法]本院2008年4月~2012年4月收治的单侧膝关节骨性关节炎患者151例,均采用单侧膝关节置换术;随机分为持续被动运动组(continuous passive motion,CPM)和自主训练组(active motion,AM)。比较两组患者年龄、性别、体重指数、手术时间、术后引流量、住院时间、对康复锻炼接受程度、美国特种外科医院膝关节评分(hospital for special surgery,HSS)、关节活动度、医院焦虑抑郁表(hospital anxiety and depression scale,HADS)等。[结果]两组在年龄、性别、体重指数、手术时间、术后引流量的差异无统计学意义(P0.05)。CPM组平均住院时间为(5.25±0.98)d,AM组为(4.36±0.59)d,AM组平均住院时间比CPM组少(0.89±0.41)d,两组间差异有统计学意义(P0.05)。CPM组中64%患者表示对CPM恐惧或勉强接受,而在AM组仅为32%(P0.05)。CPM组平均HADS评分(9.40±3.70)分,而AM组平均HADS评分(6.20±3.10)分,AM组比CPM组少(3.20±0.70)分,两组间差异有统计学意义(P0.05)。此外,AM组可明显缓解术后早期疼痛及肿胀指数,改善HSS评分及关节活动度(P0.05),但远期效果差异无统计学意义(P0.05)。[结论]"自主训练,护理辅助"的康复策略更容易被患者所接受,能早期改善关节功能、缓解局部肿胀及疼痛,是TKA术后早期功能康复训练的方法之一。
[Abstract]:[objective] to explore the degree of psychological acceptance and mental state difference between passive and active rehabilitation exercises after total knee arthroplasty, and to analyze its influence on functional recovery. [methods] from April 2008 to April 2012, 151 patients with unilateral knee osteoarthritis were treated with unilateral knee arthroplasty, and were randomly divided into two groups: continuous passive exercise group (continuous passive motility group) and autonomous training group (active motionAM). Age, sex, body mass index (BMI), operation time, postoperative drainage, hospitalization time, acceptance of rehabilitation exercise, knee joint score (hospital for special Surgery-HSS), and joint motion were compared between the two groups. Hospital anxiety and depression table (hospital anxiety and depression scaleHads, et al. [results] Age, sex, body mass index, operation time, There was no significant difference in postoperative drainage volume between the two groups (P0.05). The average hospitalization time of CPM group was (5.25 卤0.98) days. The average hospitalization time of CPM group was (4.36 卤0.59) days less than that of CPM group (0.89 卤0.41) days. The difference between the two groups was statistically significant (P0.05). 64% of the patients in CPM group expressed fear or reluctantly accepting CPM. However, the average HADS score in AM group was only 32% (P0.05). The average HADS score in AM group was (6.20 卤3.10) points lower than that in CPM group (3.20 卤0.70). There was significant difference between the two groups (P0.05). In addition, early postoperative pain and swelling index, HSS score and joint motion were significantly alleviated in AM group (P0.05), but there was no significant difference in long-term effect (P0.05). [conclusion] the rehabilitation strategy of "independent training and nursing assistance" is more easily accepted by patients, it can improve joint function early, relieve local swelling and pain. It is one of the methods of early functional rehabilitation training after TKA.
【作者单位】：河南安阳市人民医院骨一科;
【分类号】：R473.6

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