半导体激光局部照射在全膝关节置换术后康复训练中的应用

Application of Local Irradiation of Semiconductor Laser During Rehabilitation Training after Total Knee Arthroplasty

目的探讨810nm半导体激光局部照射对全膝关节置换术后疼痛及关节活动度的治疗效果。方法将60例全膝关节置换术后患者随机分为治疗组及对照组,每组30例。治疗组于置换手术后第2天开始在手术部位以波长810nm、输出功率50～100mW、光斑直径8～10cm半导体激光局部照射,照射距离5cm,照射时间10min,每日1次,10次为一疗程。同时开始使用持续被动运动(continuous passive motion,CPM)训练仪进行训练。对照组单纯使用CPM训练仪进行训练。疗程结束后两组采用视觉模拟评分法(visual analogue scale,VAS)对疗效进行比较,并分别于术后3、5和10d以量角器测量关节活动度,比较两组患者的膝关节活动度。结果总有效率治疗组为96.7%,对照组为83.3%。差异有显著意义(P<0.05)。康复治疗后3、5和10d膝关节活动度治疗组皆好于对照组,差异有显著意义(P<0.05)。结论膝关节置换术后使用810nm半导体激光局部照射,可缓解局部疼痛,消除肿胀,松解粘连,改善关节活动度,是提高术后疗效的有效治疗方法。

Objective To evaluate the clinical effect of local irradiation with 810 nm semiconductor laser on pain and the range of motion （ROM） after total knee arthroplasty （TKA）. Methods Sixty cases with TKA divided into two groups, there was a treatment group （30 cases） and a control group （30 cases） randomly. The control group was only with rehibilitation training by continuous passive motion （CMP）. The treatment group was locally irradiated with semiconductor laser at operation site the next day after arthroplasty, it was with 810 nm, power of 50-100 mW, spot size of 8-10 cm, distance of 5 cm and 10 min per each time, once a day, 10 times in a course of treatment, and also trained by CMP. We compared the clinical effect on pain after courses with the visual analogue scale （VAS）, and on the ROM at 3 d,5 d, and 10 d after operation in both control and treatment groups using the angle meter. Results The total effective rate in treatment group was 96. 7% and in control group was 83.3%, there was a significent difference between two groups （P 〈 0. 05）, the ROM at 3 d,5 d, and 10 d after rehabilitation train in treatment group was better than that in control group, there was also a significent difference between two groups （P 〈 0. 05 ）. Conclusions It is an effective way for patients after TKA that locally irradiated with 810 nm semiconductor laser, it can relax local pain and swelling, reduces adhesion and improves the ROM.