体外冲击波改善创伤性膝关节功能障碍  

Extracorporeal shock wave therapy for traumatic knee joint functional disorder

作　　者：杨杰华[1] 张盘德[1] 冼晓琪[2] 张自茂[1] 彭小文[1] 

机构地区：[1]佛山市第一人民医院康复科,广东省佛山市528000 [2]佛山市第一人民医院手术室,广东省佛山市528000

出　　处：《中国组织工程研究与临床康复》2007年第26期5179-5182,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:比较体外冲击波与关节松动术两种治疗方法对创伤性膝关节功能障碍患者的疗效。方法:选择2004-01/2006-09佛山市第一人民医院收治的63例创伤性膝关节功能障碍患者,随机数字表法随机分为体外冲击波组28例和关节松动术组35例。①治疗方法:体外冲击波组采用骨科冲击波机(深圳慧康医疗器械有限公司)进行体外冲击波治疗,60次/min、强度6～11W/cm2,时间约25min,2次/周,共6次。关节松动术组选用澳式手法和CPM仪治疗,45min/次,次/周,共治疗18次,治疗部位均为患侧膝关节。②评估指标:同时采用测角器评估患者膝关节主动和被动运动时的6关节活动范围变化,并根据关节活动范围变化评估疗效;采用目测类比评分评定活动时疼痛强度;并观察不良事件和副反应。结果:57例患者进入结果分析。①关节活动范围变化:治疗3周后,体外冲击波组膝关节活动度平均增加73.8°,关节松动术组平均增加为35.6°,两者比较差异有非常显著性意义(χ2=26.645P<0.01)。②疼痛评分结果:治疗3周后,体外冲击波组疼痛减轻47.96%,关节松动术组疼痛减轻23.73%,两者比较差异有非常显著性意义(P<0.01)。③疗效:体外冲击波组总有效率100%,关节松动术组总有效率90%。④副反应:体外冲击波组治疗后无任何不良反应,关节松动术组治疗时和后膝关节局部有疼痛剧烈,有6例因此脱落。结论:体外冲击波组治疗创伤性膝关节功能障碍的疗效优于关节松动术组,且膝关节功能障碍改善明显、疗效持久,治疗时患者痛苦少。AIM： To compare the efficacy between extracorporeal shock wave therapy （ESWT） and joint mobilization techniques for the traumatic knee joint functional disorder. METHODS： From January 2004 to September 2006, 63 patients with traumatic knee joint functional disorder were selected from the First People＇s Hospital of Foshan, and were divided into ESWT group （n =28） and joint mobilization group （n =35）. ①ESWT group was treated with shock wave instrument at the strength of 6-11 W/cm^2, 60 beats per minute, 25 minutes one time, twice a week, for six times in total. Joint mobilization group used Austrian treatment and CPM machine, 45 minutes one time, six times a week, for 18 times in total. Both therapy positions were injured knee joint.②Meantime, the clinometers was used to assess the range of motion （ROM） at the active and passive exercise of knee joint and then evaluate the curative effect; the pain scale during the movement was detected by visual observation and analogy. Additionally the adverse event and side effect were monitored. RESULTS： All of 57 patients were involved in the result analysis.①ROM： After three-week treatment, the mean ROM was increased 73.8° in ESWT group and 35.6°in joint mobilization group, there were extremely significant differences between the two groups （χ2=26.645, P 〈 0.01 ）.②Pain： After three-week treatment, the pain score was decreased 47.96% in ESWT group and 23.73% in joint mobilization group, with the extremely significant difference between the two groups （P 〈 0.01 ）. ③Curative effect： Total effectiveness rate of ESWT group was 100%, while that of joint mobilization group was 90%. ④Side effect： No adverse effect was found in ESWT group, but severe local pain of knee joint leaded to six cases dropped in joint mobilization group. CONCLUSION： ESWT is better than joint mobilization techniques to cure traumatic knee joint functional disorder. Moreover, this therapy can effect for longer time, less pain, and obvious improvement

关 键 词：体外冲击波 关节松动术 创伤性膝关节功能障碍 

分 类 号：R496[医药卫生—康复医学]