全膝关节置换术后病人一体化康复的疗效

CURATIVE EFFECT OF INTEGRATED REHABILITATION IN PATIENTS AFTER TOTAL KNEE REPLACEMENT

目的探讨全膝关节置换术（TKR）后一体化康复的疗效。方法选择行TKR病人60例,随机分为对照组和观察组,每组30例。对照组术后给予常规康复训练,观察组术后给予一体化康复训练。分别于术前及术后第3、14、90天,采用美国特种外科医院膝关节功能评分表（HSS）评价病人膝关节功能恢复情况;于术前、术后第90天行股四头肌等速肌力测定。结果术前两组膝关节HSS评分差异无显著性（P〉0.05）;术后第3、14、90天,观察组膝关节HSS评分显著高于对照组（F=5.375-29.153,P〈0.05）。观察组术后第90天与术前股四头肌峰力矩和做功量的差值高于对照组,差异有统计学意义（t=2.066、3.880,P〈0.05）。结论一体化康复训练可促进TKR后膝关节功能的恢复。

Objective To evaluate the efficacy of integrated rehabilitation after total knee replacement. Methods Sixty patients undergoing total knee replacement were selected and evenly randomized to control group and observation group. Postoperatively, a routine rehabilitation exercise was provided to patients in the control group, and for those in the observation group, rehabilitation training was provided. Employing American Special Surgery Hospital （HSS） knee function scale, the function of the knee was evaluated--before surgery and on days 3,14 and 90 after surgery, and isokinetic strength test of quadriceps muscle was done before surgery and on day 90 after surgery. Results Before surgery, the difference in HSS score of knee joint between the two groups was not significant （P-0.05）. On days 3,14 and 90 after surgery, the HSS score of knee joint in the observation group was significantly higher than that in the control group （F = 5.375-29.153, P 〈0.05）. On day 90 after surgery, the preoperative quadriceps peak torque and quadriceps work was significantly higher in the observation group versus the control group, the difference was statistically significant （t=2.066,3.880;P〈0.05）. Conclusion Integrated rehabilitation training can promote functional recovery after total knee replacement.