摘要
目的探讨行I期双侧全膝关节置换术患者的康复方法及疗效。方法2004年1月至2007年1月，共有120例患者入院接受I期双侧全膝关节置换术，按入院时间顺序随机分成交替康复组和传统康复组，2组均于术前、术后行康复训练。交替康复组采用交替法，即每个康复动作左右侧肢体交替进行；传统康复组采用传统方法进行康复训练，即一侧肢体完成一项康复训练动作后，再行对侧肢体康复训练。分别在术前1d以及术后1个月、3个月、6个月和1年记录2组的膝关节活动度、美国特种外科医院（HSS）膝关节评分和健康评定量表（SF-12）健康状态评分；记录术后2周目测类比评分法（VAS）疼痛评分和术后3个月下肢深静脉血栓（DVT）的发生率。结果115例患者完成研究，交替康复组术后早期的VAS疼痛评分较低，膝关节术后1个月和3个月的膝关节功能评分较高，SF-12健康状态评分较高，与传统康复组比较，差异有统计学意义（P〈0．01）。结论与传统康复方法相比，交替康复法对减轻I期双侧全膝关节置换术后的早期疼痛、提高膝关节术后早期功能、加快膝关节术后康复速度效果更佳。
Objective To study the outcomes of 2 rehabilitation protocols after simultaneous stage I bilateral total knee replacement （TKR）. Methods One hundred and twenty patients admitted for stage I bilateral TKR were assigned randomly to receive alternative or traditional rehabilitation therapy. Rehabilitation training was administered in both alternative and traditional groups before and after operation. In alternative group, each rehabilitation action was designed to be done on one side and the other side alternatively. In traditional group, each training session was designed to be done on one side and then followed by the other side in succession. Visual analogue scale （VAS） scores were evaluated for 2 weeks after operation and deep vein thrombosis （DVT） complications were recorded for 3 months after operation. The range of motion （ROM） , American hospital special surgery （HSS） knee scores and SF-12 scores were recorded at 1 d before operation and the 1st, 3rd, 6th and 12th month after operation. Results One hundred and fifteen patients completed all training sessions and assessments. Compared with traditional group, ahernative group had significantly lower VAS scores in the early postoperation stage and significantly better knee function scores and SF-12 scores at the 1st and 3rd month postoperation （P 〈 0. 005）. Conclusion The alternative protocol can speed up rehabilitation and lead to decrease VAS scores in the early postoperation stage, and improve knee function and physical and mental health after TKR.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2009年第8期542-546,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
全膝关节置换术
双侧
康复
疗效
Total knee arthroplasty, bilateral
Rehabilitation
Outcome
