围术期团体辅导对关节镜下肩袖修复术后患者肩关节功能康复的影响

Effect of Perioperative Group Counseling on Improving Shoulder Function after Arthroscopic Rotator Cuff Surgery

【目的】分析围术期团体辅导对于肩关节镜下肩袖修复术患者术后肩关节功能康复的影响,为其临床应用提供参考。【方法】将2017年8月至2019年5月在湖南省人民医院因肩袖损伤而行肩关节镜下肩袖修复术的患者共180例,随机分为观察组和对照组,每组各90例。对照组采用常规围术期康复干预,观察组开展肩关节手术围术期团体辅导。比较两组患者术前、术后1个月、术后3个月、术后6个月的疼痛视觉模拟评分(VAS)、肩关节活动度、美国肩肘外科评分系统(ASES)评分、美国加州大学肩关节评分系统(UCLA)评分等指标。【结果】①两组患者术前肩关节活动度、VAS评分、UCLA评分、ASES评分差异均无显著性(P>0.05);②观察组患者术后1个月、3个月、6个月的VAS评分、UCLA评分、ASES评分、肩关节活动度均优于对照组(P<0.05);③术后6个月-术前差值、差值绝对值比较,试验组患者的VAS评分、UCLA评分、AS-ES评分、肩关节活动度均优于对照组(P<0.05)。【结论】①围术期团体辅导模式较常规围术期康复干预模式对肩关节镜下肩袖修复术患者的康复效果更佳;②干预方式和治疗时间是改善患者疼痛程度、肩关节功能及活动度的主要因素,且二者无交互作用。

【Objective】To explore the clinical effect of perioperative grbup counseling for patients who had shoulder arthroscopic rotator cuff repair.To provide the theory basis for the application of perioperative group counseling mode and lay the theoretical foundation for clinical promotion.【Methods】A total of 180 patients who had the shoulder arthroscopic rotator cuff repair in Hunan Provincial Peoples Hospital from August 2017 to May 2018 were randomly divided into two groups which were the routine rehabilitation group(the control group)and the counseling group(the observation group).And each group had 90 patients.The pain score(VAS),range of motion of shoulder,American Shoulder and Elbow Surgical Scoring Scale(ASES),UCLA shoulder Scoring System(UCLA)and other indicators were compared before the operation,1 month,3 months and 6 months after surgery.【Results】(1)There were no significant differences in preoperative VAS score,UCLA score and ASES score between 2 groups(P〉0.05);(2)At 1,3 and 6 months after surgery,the VAS score,UCLA score,ASES score and range of motion of shoulder in the observation group were better than those in the control group(P<0.05);(3)The difference and absolute value of difference between pre-operation and 6 months after surgery showed that the VAS score,UCLA score,ASES score,range of motion of shoulder joint and practice rate of patients in the observation group were better than those in the control group(P<0.05).【Conclusion】(1)Pain relief,treatment satisfaction,shoulder function and range of motion are improved in both groups.(2)Compared to the conventional mode,perioperative group counseling mode has better effects on postoperative patients.(3)Intervention mode and intervention time are the main factors to improve pain degree»shoulder function and range of motion.There is no interaction between Intervention mode and intervention time.