冲击波与超声波疗法治疗创伤后膝关节功能障碍的疗效比较

Efficacy of extracorporeal shock wave therapy vs. ultrasound treatments for post-traumatic knee dysfunction

目的:比较冲击波和超声波治疗创伤后膝关节功能障碍的疗效。方法:60例单侧创伤后膝关节功能障碍患者被随机分成2组,冲击波组和超声波组各30例。2组均给予综合康复治疗(关节松动术、肌力训练和冷疗)。冲击波组增加冲击波治疗,每周2次,共8次。超声波组增加超声波治疗,每天1次,每周5天,共20次。在治疗前、治疗4周后评估患者的疼痛视觉模拟(VAS)评分、膝关节被动关节活动度(ROM)和膝关节功能(HSS)评分。结果:治疗4周后,2组患者VAS评分均较治疗前明显下降(均P<0.01),膝关节ROM和HSS评分均较治疗前明显增加(均P<0.05);治疗后2组间比较,冲击波组的VAS评分比超声波组明显降低(P<0.01),膝关节ROM和HSS评分均较超声波组有明显增加(均P<0.01)。结论:对于创伤后膝关节功能障碍的患者,冲击波治疗可以比超声波治疗更好地缓解关节疼痛,有效增加膝关节关节活动度和改善膝关节功能。

Objective: To compare the efficacy of extracorporeal shock wave therapy (ESWT) vs . ultrasound (US) in the treatment of post-traumatic knee dysfunction. Methods: A total of 60 patients with post-traumatic unilateral knee dysfunction were randomly assigned to 2 groups: ESWT group and US group. All patients were given a rehabilitation method including joint mobilization,strength training and cold therapy. ESWT group received ESWT for 8 sessions twice per week. US group received US for 20 sessions. The patients were evaluated before and 4 weeks after treatment. Measurements were made using visual analogue scale (VAS),passive range of motion (ROM) and hospital for special surgery knee score (HSS). Results: Both groups showed significant improvements in terms of VAS ( P < 0.01 ),passive ROM ( P < 0.01 ) and HSS ( P < 0.01 ) after treatment. The VAS scores in the ESWT group were reduced significantly as compared with those in the US group ( P < 0.01 ). The ROM and HSS scores in the ESWT group increased significantly as compared with those in the US group ( P < 0.01 ). Conclusion: It is suggested ESWT is significantly more effective than US in the treatment of post-traumatic knee dysfunction.