摘要
目的分析患者跟腱微创修复术后康复疗法对功能影响与临床意义。方法2008年8月至2013年1月，我科收治并获得随访的92例行跟腱微创修复术的患者，术后按照收治顺序的单双数序号随机分为两组：其中运动康复疗法组48例全部获得随访，男46例，女2例，年龄18～50岁，平均34．3岁。左侧30例，右侧18例。术后严格按照我们制定的图文制式运动康复疗法指南进行渐进性康复训练；自然康复组失访4例，获得随访的44例中男42例，女2例，年龄21—52岁，平均35．1岁，左侧26例，右侧18例。术后由医生口头交待术后康复注意事项。随访按照Amer—Lindholm疗效评定标准进行评定，采用SPSS13．0软件将评定结果进行计量数据的统计学分析，从而进行组间差异性比较。结果随访时间8—48个月，平均19．6个月。运动康复疗法组及自然康复组均无感染病例，自然康复组再断裂4例，3例接受再手术，1例选择保守治疗。运动康复疗法组无跟腱再断裂。根据Arner—Lindholm评定法，运动康复疗法组优34例，良13例，差1例，总体优良率97．91％（47／48）；自然康复组优18例，良21例，差5例，总体优良率88．63％（39／44）。组间差异统计分析显示运动康复组功能优良率显著高于自然康复组（P=0．014）。结论本科制定的跟腱微创修复术后运动康复计划高效可靠，对恢复功能和防止再断裂至关重要。是值得推广的跟腱微创修复术后的康复锻炼方法。
Objective To analyze the effects of sports rehabilitation therapy on the functional recovery in patients after minimally invasive Achilles tendon repair surgery and its clinical significance. Methods From August 2008 to January 2013, 92 patients were treated with minimally invasive Achilles tendon repair surgery in our institute, and then were followed up. According to the odd or even number of each patient when adopted, all patients were randomly divided into 2 groups postoperatively, including 48 patients in sports rehabilitation therapy group （ group A ）, who underwent progressive rehabilitation training strictly in accordance with the graphic rehabilitation guidelines as we planned, and 44 patients （ 4 missing cases ） in spontaneous recovery group （ group B ）, who got to know the matters needing attention about the postoperative rehabilitation as doctors instructed verbally. In group A, there were 46 males and 2 females, whose average age was 34.3 years old （ range; 18-50 years ）, including 30 patients in the left side and 18 patients in the right side. In group B, there were 42 males and 2 females, whose average age was 35.1 years old （ range; 21-52 years ）, including 26 patients in the left side and 18 patients in the fight side. The functional recovery was evaluated by the Arner-Lindholm evaluation criteria and the statistical analysis of measurement data was performed using the s＆cware Statistical Package for Social Science （ SPSS ） 13.0. And then the differences between the 2 groups were compared. Results All patients were followed up for an average period of 19.6 months （ range; 8-48 months ）. No infection was found in both groups. In group B, tendon re-rupture occurred in 4 cases, re-operation in 3 cases and conservative treatment in 1 case. No tendon re-rupture occurred in group A. According to the Arner- Lindholm evaluation criteria, there were 34 excellent cases, 13 good cases and 1 poor case in group A, and the total excellent and good rate was 97.91% （ 47/48 ）. In group B, there were 18 excellent cases, 21 good cases and 5 poor cases, and the total excellent and good rate was 88.63% （ 39/44 ）. The differences in the excellent and good rate between the 2 groups were statistically significant （ P=-0.014 ）. Conclusions The sports rehabilitation therapy after minimally invasive Achilles tendon repair surgery planned by us is effective and reliable, and play a key role in promoting functional recovery and preventing re-rupture. It is worthy of promotion.
出处
《中国骨与关节杂志》
CAS
2013年第11期641-644,共4页
Chinese Journal of Bone and Joint
关键词
跟腱
功能恢复
踝关节
外科手术
微创性
Achilles tendon
Recovery of function
Ankle joint
Surgical procedures, minimally invasive
