全膝关节置换术后康复锻炼专案改善方案临床应用效果观察

Observation on clinical application effect of rehabilitation exercise project-improvement program after total knee arthroplasty

目的:探讨全膝关节置换术后康复锻炼专案改善方案的临床应用效果。方法:选择2019年1月—2021年1月我院收治的全膝关节置换术病人118例,随机分为两组,各59例。对照组行常规康复锻炼,观察组在此基础上引入专案改善方案。比较两组术后康复情况、住院时间、术后膝关节活动能力、膝关节功能评分、日常生活活动能力评分、并发症发生率。结果:观察组实现直腿抬高时间、实现屈膝90°时间、初次下床活动时间、住院时间分别为(32.06±10.07)h、(23.29±5.71)h、(21.74±4.58)h、(4.15±0.95)d,对照组实现直腿抬高时间、实现屈膝90°时间、初次下床活动时间、住院时间分别为(43.61±9.58)h、(34.15±9.38)h、(51.37±8.09)h、(6.16±0.92)d,两组比较差异均有统计学意义(P<0.001);观察组术后第5天最大屈曲度、借助步行器行走距离大于对照组(P<0.001);观察组术后第7天、术后1个月膝关节评分、日常生活活动能力评分均高于对照组(P<0.001);观察组术后并发症发生率低于对照组(8.47%与37.29%,P<0.001)。结论:全膝关节置换术后病人康复锻炼中引入专案改善方案可促进病人膝关节功能恢复,提高日常生活能力,降低并发症发生率,缩短住院时间。

Objective:To explore the clinical application effect of rehabilitation exercise project-improvement-program in patients after total knee arthroplasty(TKA).Methods:A total of 118 patients with TKA treated in our hospital from January 2019 to January 2021 were randomly divided into two groups,with 59 cases in each.The control group received routine rehabilitation exercises,and the observation group received a project-improvement program based on the control group.The postoperative rehabilitation,length of stay,the score of postoperative knee mobility and knee function,the score of activities of daily living(ADL),and complication rates were compared between the two groups.Results:In the observation group,the time to achieve straight leg raising,time to achieve 90° knee flexion,time to get out of bed for the first time,and length of stay were(32.06±10.07)h,(23.29±5.71)h,(21.74±4.58)h,(4.15±0.95 d),respectively.In the control group,the time to achieve straight leg raising,the time to achieve 90° knee flexion,the time to get out of bed for the first time,and the length of stay were(43.61±9.58)h,(34.15±9.38)h,(51.37±8.09)h,and(6.16±0.92)d,respectively.The difference between the two groups was statistically significant(P<0.001).The maximum flexion degree and walking distance with a walker in the observation group on the 5 th day after operation were higher than those in the control group(P<0.001).The knee joint and ADL scores on the 7 th day and 1 month after operation were higher than those in the control group(P<0.001).The incidence of postoperative complications in the observation group was lower than in the control group(8.47% vs 37.29%,P<0.001).Conclusions:The rehabilitation exercise project-improvement program applied in the patients after TKA could promote the recovery of knee joint function,improve the ADL,reduce the incidence of complications,and shorten the length of stay.