人工全膝关节置换老年患者围手术期系统康复

The systemic rehabilitation for early postoperative elderly individuals following total knee replacement in Peri-operation period

目的探讨规范化系统康复治疗对全膝关节置换术后老年患者关节功能恢复的作用。方法选择TKR手术患者60例,随机分成系统康复训练组(30例)和对照组(30例)。两组均接受骨科常规治疗和护理。康复组除接受骨科常规治疗和护理外,入院后根据患者情况由康复医学科进行系统的康复方案治疗,于手术治疗前2d,手术后第2天、第7天及第14天进行膝关节评分(HSS)、膝关节活动范围(ROM)、疼痛视觉模拟量表(VAS)评定。结果康复组和对照组手术前以及手术后第2天各项数据经统计学分析差异无统计学意义(P>0.05),康复组在第7天和第14天HSS关节和功能评分值及VAS评分值优于对照组(P<0.05,P<0.01),ROM测定值均优于对照组(P<0.01)。结论系统康复治疗可促进TKR术后患者的功能尽早恢复,减轻患者手术后的疼痛,增加手术后膝关节的关节活动范围。

Objective To discuss the effects of early postoperative individuals rehabilitation following total knee replacement（TKR）. Method Sixty patients were randomly divided into rehabilitation group and control group, 30 subjects each. All patients suffered from knee osteoarthritis were underwent the operation in hospital. All patients got the normal nursing care. In addition, the rehabilitation group got the individual rehabilitation systematically. Patients were evaluated at the 2nd day before operation, the 2nd, the 7th and the 14th day after operation. The evaluation indexes involved the hospital special surgery knee score（HSS）, knee range of motion（ROM）,and visual analogue scale（VAS）. Result All the evaluation indexes had no differences between rehabilitation group and control group before operation and the 2nd day after operation（P〉0.05）. At the 7th and 14th day after operation, HSS and VAS in rehabilitation group was better than those in control group （P 〈 0. 05, P〈 0. 01）. The knee ROM in rehabilitation group was much better than that in control group（P〈0.01）. Conclusion Individual rehabilitation program could facilitate function restoration and significantly improve range of motion for the patients after TKR.