超激光治疗结合康复训练对全膝关节置换术后疼痛和生活质量的影响

Effects of super laser combined with rehabilitation training on postoperative pain and quality of life following total knee replacement

目的:探讨超激光治疗结合康复训练对全膝关节置换术(TKR)后疼痛、功能和生活质量的影响。方法:选取TKR术后患者52例,随机分为2组各26例。对照组患者给予常规康复治疗(包括术后良肢位摆放、关节活动度训练、肌力训练、转移训练、平衡功能训练、本体感觉训练和步行能力训练);观察组在此基础上,进行超激光治疗。分别于治疗前和治疗6周后进行评价,指标包括视觉模拟评分法(VAS),膝关节主动关节活动度(AROM),膝关节功能评分(HSS)和简版生活质量量表(SF-12)评价临床疗效。结果:治疗6周后,2组患者VAS评分均较治疗前明显下降(P<0.05),且观察组低于对照组(P<0.05);2组HSS膝关节功能评分及膝关节AROM屈曲、伸展角度均较治疗前明显提高(P<0.05),且观察组高于对照组(P<0.05);2组SF-12量表心理总得分(MCS)和生理总得分(PCS)及总分均较治疗前明显提高(P<0.05),且观察组高于对照组(P<0.05)。结论:对初次行TKR的术后患者进行超激光治疗结合康复训练临床疗效确切,可改善患者的膝关节功能、心理功能和缓解疼痛,疗效优于常规治疗组,而且显著提高患者的生活质量。

Objective： To investigate the effectiveness of super laser combined with rehabilitation training on postoperative pain and quality of life following total knee replacement. Methods： From March 2016 to February 2017, 52 patients, whose first diagnosis was knee osteoarthritis, underwent primary total knee replacement in the Guangdong Provincial Work Injury Rehabilitation Hospital. The patients were randomly divided into two groups： the experimental group （super laser group） and control group, with 26 subjects in each group. The patients in the control group received conventional rehabilitation training （i.e., positioning post-surgery, range of motion training, transfer training, balance training, proprioception training and walking ability training）, and those in the experiment group were treated with super laser additionally. The rehabilitation effects of the two groups were evaluated respectively before and 6 weeks after operation using Visual Analogue Scale （VAS）, Active Range of Motion （AROM）, Hospital for Special Surgery （HSS） knee functional score and 12-item short form health survey （SF-12）. Results： VAS, AROM, HSS knee functional scores and SF-12 were significantly improved after 6-week treatments in both two groups when compared with those before treatments （P〈0.05）. The above scores were significantly better in the experimental group than in the control group （P〈0.05）. Conclusion： The rehabilitation effectiveness was definite for patients who had been given super laser combined with rehabilitation training after primary total knee replacement. The training also had better rehabilitation effectiveness in improving knee, mental function and relieving pain as compared with conventional rehabilitation training. And the training can significantly improve the quality of life of patients.