膝关节前交叉韧带损伤后下肢肌力变化的等速测试研究

A Isokinetic Testing Study on the Changement of Muscle Strength in the Patients with Anterior Cruciate Ligament Injury

目的：研究膝关节前交叉韧带损伤后患者膝关节周围肌肉力量的减退情况及其与受伤时间的关系,为前交叉韧带损伤重建手术时机的选择提供依据。方法：选择2010年1月-2013年10月之间单侧膝关节单纯前交叉韧带损伤患者194例为研究对象,应用等速测试仪进行膝关节屈伸肌峰力矩（PT）、相对峰力矩（PT/BW）、屈伸肌峰力矩比（H/Q）及总功（TW）测试,分析并比较肌力变化与受伤时间的关系。结果：患肢与健肢比较,伤后膝关节屈伸肌的PT、PT/BW、TW值均明显减低,H/Q值显著升高,差异均有统计学意义（P〈0.01）。受伤时间与肌力减退明显相关,随受伤时间延长,屈伸肌PT值逐渐下降（r=-0.813;r=-0.852）,4组屈伸肌的PT值比较差异均有统计学意义（P〈0.05）,其中1月之内组患者屈伸肌的PT值最高。结论：膝关节前交叉韧带损伤后,患肢肌力随时间延长会逐渐下降,前交叉韧带损伤后重建应尽可能地选择在术后1月内及术后3-6个月内肌肉力量相对较好的时间段进行。

Objective： To investigate the relationship between muscle strength and injure time in the patients with anterior cruciate ligament rupture.To provide the basis for the choice of anterior cruciate ligament injury reconstruction operation time.Method：194 cases with unilateral ACL rupture were selected from January 2010 to Octomber 2013 as research objections.The PT value,PT/BW value,H/Q value and TW value of patients were obtained by isokinetic testing. The relationship between the injury time and these values was analyzed.Result：Compared with the healthy side, the PT value,PT/BW value and TW value of the injured side decreased significantly,the H/Q increased,the differences were statistically significant（P〈0.01）.Injury time was associated with decreased muscle strength obviously, with the extension of injury time, flexor PT values gradually decline （r=0.813;r=0.852）, compared four groups of flexor PT value,the differences were statistical significance （P〈0.05）,within one month of flexor PT value was the highest.Conclusion： In patients with anterior cruciate ligament injury, muscle strength of injured limb would gradually declined according to the injure time. The surgery treatment of patients with anterior cruciate ligament injury should be taken within 1 month or in 3 months to 6 months when the muscle strength of the injured limb is better.