体外冲击波联合系统康复训练对胫骨平台骨折患者术后功能康复的影响

Effect of Extracorporeal Shock Wave Combined System Rehabilitation Training on Postoperative Functional Rehabilitation of Patients with Tibial Plateau Fractures

目的探讨体外冲击波联合系统康复训练在胫骨平台骨折术后患者中的应用价值.方法选择该院2018年5月—2020年5月收治的胫骨平台骨折手术患者74例,按随机数字表法分为两组,每组37例.对照组术后予以系统康复训练,观察组在对照组基础上加用体外冲击波干预,均干预6个月.对比分析两组的膝关节功能康复情况、肌力恢复情况、胫骨平台内翻角(tibial plateau angle,TPA)及后倾角(posterior slope angle,PSA)度数.结果两组术前的美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)评分相比,差异无统计学意义(P>0.05);两组术后6个月的HSS评分均高于术前,且观察组(85.38±5.12)分高于对照组(74.19±5.01)分,组间差异有统计学意义(P<0.05).术后6个月,观察组的徒手肌力评定分级优于对照组,差异有统计学意义(P<0.05).术后6个月,两组的TPA小于术后1个月,PSA大于术后1个月,且观察组术后1、6个月的TPA均小于对照组,PSA均大于对照组,组间差异有统计学意义(P<0.05).结论体外冲击波联合系统康复训练能够有效促进胫骨平台骨折患者术后膝关节功能恢复,提高肌力,矫正TPA、PSA,对患者术后恢复起积极的作用.

Objective To explore the application value of extracorporeal shock wave combined system rehabilitation training in patients after tibial plateau fractures surgery.Methods The 74 patients with tibial plateau fractures surgery admitted to this hospital from May 2018 to May 2020 were selected and divided into two groups according to the random number table method,with 37 cases in each group.The control group received systematic rehabilitation training after the operation,and the observation group was treated with extracorporeal shock wave intervention on the basis of the control group,all of which were intervened for 6 months.The knee joint functional rehabilitation,muscle strength recovery,tibial plateau angle(TPA)and posterior slope angle(PSA)degrees were compared and analyzed between the two groups.Results There was no significant difference between the two groups of hospital for special surgery knee score(HSS)scores before surgery(P>0.05);the HSS scores of the two groups at 6 months after operation were higher than those of the preoperative group,and the observation group(85.38±5.12)score was higher than the control group(74.19±5.01)score,the differences between the groups were statistically significant(P<0.05).At 6 months after the operation,the grading of the manual muscle testing of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).At 6 months after surgery,the TPA of the two groups was less than 1 month after surgery,and the PSA was greater than 1 month after surgery,and In addition,the TPA of the observation group at 1 and 6 months after operation were lower than those of the control group,and the PSA of the observation group were higher than those of the control group,the differences between the groups were statistically significant(P<0.05).Conclusion Extracorporeal shock wave combined system rehabilitation training can effectively promote the postoperative knee function recovery of patients with tibial plateau fractures,improve muscle strength,correct TPA and PSA,and play a positive role in postoperative recovery of patients.