全膝关节置换术后不同时间开始主动功能锻炼对炎症程度的影响

Influence of active functional exercise on the degree of inflammation after total knee arthroplasty

目的探讨全膝关节置换术后不同时间开始主动功能锻炼对炎症程度的影响。方法选取肇庆市高要区中医院2017年1月~2020年1月收治的92例接受全膝关节置换术的患者作为研究对象,按照随机数字表法分为研究组(46例)与对照组(46例)。对照组采用术后3 d内开始主动功能锻炼的方法,研究组采用术后当天开始主动功能锻炼的方法。比较两组的肿瘤坏死因子(TNF)-α、白细胞介素(IL)-lβ、IL-6水平及患肢活动度、患肢肿胀度。结果干预前,两组TNF-α、IL-lβ、IL-6水平比较,差异无统计学意义(P>0.05);两组术前患肢活动度、患肢肿胀度比较,差异无统计学意义(P>0.05);两组术后14 d患肢肿胀度比较,差异无统计学意义(P>0.05);干预后,研究组TNF-α、IL-1β、IL-6水平低于对照组,差异有统计学意义(P<0.05);研究组术后3、7、14 d的患肢活动度高于对照组,差异有统计学意义(P<0.05);研究组术后3、7 d的患肢肿胀度低于对照组,差异有统计学意义(P<0.05)。结论全膝关节置换术结束麻醉清醒后开始主动功能锻炼,有利于改善炎症程度,有效改善患者的膝关节活动度,促进关节功能恢复,在临床上值得进一步应用。

Objective To investigate the effect of active functional exercise at different times after total knee arthroplasty on the degree of inflammation.Methods From January 2017 to January 2020,a total of 92 cases of patients undergoing total knee replacement in Zhaoqing City Gaoyao District Hospital of Traditional Chinese Medicine were selected as the research objects,they were divided into research group(46 cases)and control group(46 cases)according to the random number table method.The control group adopted the method of active functional exercise within 3 days after the operation,and the research group adopted the method of active functional exercise on the same day after the operation.The levels of tumor necrosis factor(TNF)-α,interleukin(IL)-lβ,IL-6,limb mobility and limb swelling were compared between the two groups.Results Before intervention,there were no statistically significant differences at the levels of TNF-α,IL-lβand IL-6 between the two groups(P>0.05);there were no statistically significant differences between the two groups in the mobility and swelling degree of the affected limb before operation(P>0.05);there was no statistically significant difference between the two groups in the degree of limb swelling 14 days after surgery(P>0.05);after intervention,the levels of TNF-α,IL-1βand IL-6 in the control group were lower than those in the control group,with significant differences(P<0.05);the range of motion of affected limbs in the control group were higher than those in the control group at 3,7 and 14 days after surgery(P<0.05);the swelling degree of the affected limb in the control group was lower than that in the control group at 3,7 and 14 days after surgery,and the differences were statistically significant(P<0.05).Conclusion After total knee arthroplasty finishes anesthesia and wakes up,active functional exercise is helpful to improve the degree of inflammation,effectively improve the knee joint mobility of patients,and promote the recovery of joint function.It is worthy of further application in clinical practice.