骨科康复一体化模式对全膝关节置换术后功能恢复影响的临床研究

发布时间：2018-03-07 23:13

本文选题：全膝关节置换术　切入点：骨科康复一体化模式　出处：《中国康复医学杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的:评价骨科康复一体化治疗模式运用于全膝关节置换术对膝关节疼痛、功能及生存质量的改善效果,比较其与常规治疗模式干预的康复疗效差异。方法:将2014年5月—2015年3月前来解放军总医院第一附属医院关节外科就诊,第一诊断为膝关节骨性关节炎且初次行全膝关节置换术的患者94例,按就诊顺序随机分为观察组(47例)和对照组(47例),观察组给予骨科康复一体化治疗模式干预,对照组给予常规治疗模式干预,分别于术前和术后1周、4周、12周、24周采用膝关节主动关节活动度(active range of motion,AROM),数字疼痛评分(numeric rating scale,NRS)、HSS膝关节功能评分,以及生活质量量表(MOS 12-item short form health survey,SF-12)评价康复疗效。结果:术前两组患者膝关节AROM、NRS、HSS膝关节功能评分、SF-12量表中的心理总得分(physical component summary,MCS)和生理总得分(mental component summary,PCS)无差异(P0.05);术后1、4周时观察组膝关节AROM、SF-12量表中MCS均优于对照组(P0.05),但NRS两组无差异(P0.05);术后1周时膝关节HSS评分、SF-12量表中的PCS组间比较无差异(P0.05);术后4周时观察组的膝关节HSS评分、SF-12量表中的生理总得分(PCS)均优于对照组(P0.05);术后12周及24周时观察组AROM、NRS、HSS膝关节功能评分及SF-12量表中的PCS、MCS均明显优于对照组(P0.05)。结论:对初次行全膝关节置换术的患者进行骨科康复一体化治疗模式干预后的康复疗效确切,其对改善膝关节功能、患者的心理功能以及缓解疼痛的康复疗效优于常规的治疗模式且显著提高患者的生活质量。
[Abstract]:Objective: to evaluate the effect of orthopedic rehabilitation integrated therapy on knee pain, function and quality of life in total knee arthroplasty. Methods: from May 2014 to March 2015, the patients were admitted to the first affiliated Hospital of PLA General Hospital for treatment of joint surgery. Ninety-four patients with the first diagnosis of osteoarthritis of the knee and undergoing total knee arthroplasty were randomly divided into observation group (n = 47) and control group (n = 47). The observation group was treated with orthopedic rehabilitation integrated treatment mode. The control group was treated with routine treatment mode. The knee joint function was evaluated by using the active range of the knee joint and the digital pain score before and after 1 week, 4 weeks, 12 weeks and 24 weeks, respectively, and the digital pain score was used to evaluate the function of the knee joint. And quality of life scale (MOS 12-item short form health survey SF-12). Results: there was no significant difference in the scores of physical component summaryMCSs and physiologic component summaryPCSs between the two groups before operation (P 0.05), and there was no significant difference between the two groups in the score of knee joint function of AROMU NRSS-HSS and SF-12 scale (P 0.05). The MCS of AROMN SF-12 in the observation group was better than that in the control group (P 0.05), but there was no difference between the two groups in NRS (P 0.05); there was no significant difference in the HSS score of the knee joint between the two groups at 1 week after operation; there was no difference between the PCS groups in the SF-12 scale at 1 week after operation; and the HSS score of the knee joint in the observation group at 4 weeks after operation was significantly higher than that in the control group (P 0.05). The total physiological score in the table was better than that in the control group (P 0.05), and at 12 and 24 weeks after operation, the score of knee joint function in the observation group was significantly better than that in the control group (P 0.05). Conclusion: the patients undergoing total knee arthroplasty for the first time in the observation group are better than those in the control group in the score of the knee joint function of AROMN NRSs and the SF-12 scale. Conclusion: the patients undergoing total knee arthroplasty for the first time are treated with total knee replacement. The rehabilitation effect after intervention of orthopedic rehabilitation integrated treatment mode was definite. It can improve the function of knee joint, the psychological function of patients and the rehabilitation of pain relief. It is superior to the routine treatment mode and improves the quality of life of the patients.
【作者单位】：锦州医科大学;解放军总医院第一附属医院骨科研究所;
【基金】：2013年度北京市科技计划重大项目(D131100004913003)
【分类号】：R687.4

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