关节活动系统及持续被动运动技术对髌骨骨折术后患者疼痛及活动受限的疗效研究

Study on the Curative Effect of Joint Activity System and Continuous Passive Motion Technique on the Pain and Limited Movement in Postoperative Patients with Patellar Fracture

目的观察关节活动系统(joint activity system,JAS)、持续被动运动(continuous passive motion,CPM)技术、关节松动术对髌骨骨折术后患者疼痛及关节活动度恢复的疗效,并比较其疗效差异性。方法选取2015年1月至2017年10月成都第一骨科医院髌骨骨折术后患者120例随机分为A组、B组、C组,每组60例,A组采用JAS治疗,2d/次,每次时间为15min左右,5d/周,持续4周,再配合手法关节松动术,30~45min/次,2次/d,5d/周,共4周。B组采用CPM技术进行治疗,CPM时间为30min/次,2次/d,5d/周,持续4周,再配合手法关节松动术。C组只选用单纯关节松动术进行治疗。在治疗前、治疗结束时、治疗结束后半年对患者进行膝关节功能HSS评分标准判定。结果经过治疗,3组患者在治疗结束后及随访时的HSS疼痛评分均有所提高,关节活动度也有明显改善;A、B组的在疼痛及关节活动度上的HSS评分高于C组,差异具有统计学意义(P<0.05)。结论JAS、CPM治疗、关节松动术为治疗髌骨骨折术后患者疼痛、关节活动度恢复的有效方法;JAS及CPM技术方法简单、安全,并发症少,能迅速缓解疼痛,改善关节活动度,改善老年人生活质量,具有较好的远期疗效。若能在临床上可联合关节松动术使用,能缩短治疗时间,提高疗效。

Objective To observe the effect of joint activity system (JAS), continuous passive motion (CPM) technique and joint mobilization on the recovery of pain and joint activity in postoperative patients with patellar fracture and compare the difference of the curative effect. Methods A total of 120 postoperative patients with patella fracture treated in No. 1 Orthopaedics Hospital of Chengdu from January of 2015 to October of 2017 were selected and divided randomly into Group A, Group B and Group C with 60 cases in each group. Group A was treated with JAS of about 15 minutes combined with joint mobilization of about 30 to 45 minutes. The treatment was given twice each day for 5 days each week and lasted consecutively for 4 weeks. Group B was treated with the CPM technique of 30 minutes combined with joint mobilization. The treatment was given twice each day for 5 days each week and lasted consecutively for 4 weeks. Group C was treated only with joint mobilization. The patients' knee joint function was assessed by the HSS scoring system before treatment, at the end of treatment and half a year after treatment, respectively. Results The HSS pain scores were improved and the joint activity was ameliorated significantly after treatment and during the follow-ups in the three groups. The HSS pain scores and joint activity after treatment were significantly better in Group A and Group B than in Group C ( P <0.05). Conclusion JAS, CPM technique and joint mobilization are effective in the recovery of the pain and joint activity in postoperative patients with patella fracture. JAS and CPM technique are simple and safe with fewer complications, and they can quickly relieve pain, improve joint activity and improve the elderly's quality of life with good long-term efficacy. If they are used clinically in combination with joint mobilization, they can shorten the treatment time and improve the curative effect.