关节镜下异体骨-髌腱-骨前交叉韧带重建术围手术期的护理

The perioperation nursing of reconstruction of anterior cruciate ligament by bone- patellar tendon- bone alIograft under arthroscopy

目的探讨膝关节镜下异体骨-髌腱-骨前交叉韧带（ACL）重建术后早期功能锻炼的方法,最大限度地减少合并症及功能障碍等不良反应。方法对8例前交叉韧带损伤患者实施异体骨-髌腱前交叉韧带重建术,术后通过使用可调式支具外固定、被动活动器（CPM）、被动及主动功能锻炼等康复护理。结果8例术后均获随访,时间为27-77个月,平均41个月。按Lukianov的ACL重建术后功能评定标准,优8例。随访结果显示,术前7例Lanchman试验阳性,术后均阴性;术前6例前抽屉试验阳性,术后均呈阴性;术前6例有明显膝关节不稳定感,术后均消失;术后8例功能锻炼后膝关节活动度可达0-90°。结论ACL重建术后早期进行综合康复训练明显有利于膝关节功能的恢复。

Objective To explore a method for early function training after the operation of reconstruction of anterior cruciate ligament （ACL） by bone-patellar tendon-bone allograft under arthroscopy, and to reduce the complications and the adverse reactions such as function obstacle. Methods 8 patients with ACL injury were conducted the operation of reconstruction of anterior cruciate ligament by patellar tendon-bone allograft. After the operation, the rehabilitation nursing of the patients was completed through using external fixation of adjustable brace, continuous passive movement （CPM）, and passive and active function exercises. Results 8 patients were followed up 27 to 77 months after the operation, with an average time of 41 months. According to function assessment of reconstruction of ACL by Lukianov, the patients were evaluated and 8 cases were classified as excellent. The following-up resuits showed that the Lanchman test was positive in 7 cases preoperatively and all cases were negative postoperatively. In addition, the anterior drawer test was positive in 6 cases preoperatively and all cases were negative postoperatively. Instability existed in 6 cases preoperatively were disappeared after the operation. The activity degree of knee joint in 8 cases could reach 0-90 degree after the function exercise. Conclusions The early rehabilitation exercise after the reconstruction operation is helpful to the recovery of function of knee joint obviously.