QS mini切口膝关节置换辅以早期康复治疗16例  

QS mini-incision knee replacement accompanied by early rehabilitation in 16 cases

作　　者：屈波[1] 张锦佳[1] 孔丹[1] 周勇刚[1] 陈华[1] 

机构地区：[1]解放军总医院骨科,北京市100853

出　　处：《中国组织工程研究与临床康复》2009年第43期8582-8585,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察QSMini切口膝关节置换辅以专业康复治疗对膝关节骨性关节炎的治疗效果。方法:回顾性分析2005-06/2006-08解放军总医院骨科收治的膝关节骨性关节炎患者16例作为实验组,男4例,女12例,年龄59～77(65.3±5.3)岁,病程10～15(13.4±4.3)年;16例患者均行Mini切口膝关节置换,辅以专业康复护理方案配合康复,康复护理方案涉及心理疏导、置换前训练、置换后肌力训练、不良步态纠正、关节位置觉训练以及置换后全身功能协调训练,特别强调早期股四头肌主动伸膝直腿抬高练习。以行常规膝关节置换的12例膝关节骨性关节炎患者为对照,男5例,女7例,年龄60～75(67.5±4.7)岁,病程8～18(12.8±4.9)年。采用目测类比评分评价疼痛程度,量角器测量关节活动角度,HSS评分评价关节功能。结果:患者住院时间为10～16(13.2±2.7)d,平均13d。28例患者均获得随访,随访时间9～12个月。两组患者置换前膝关节疼痛程度、活动度及功能情况无显著性差异。置换后关节疼痛程度、活动度及功能均明显改善,出院及随访时实验组关节屈曲活动度和HSS评分均高于对照组(P<0.05)。结论:在保存股四头肌完整性、减少术中损伤等理念下进行QSMini切口人工膝关节置换,辅以心理疏导、置换前训练、置换后肌力训练、不良步态纠正、关节位置觉的训练以及置换后全身功能协调训练的治疗方案能够显著提高膝关节置换后的功能。OBJECTIVE： To analysis outcomes of patients with knee osteoarthritis treated by mini-incision knee replacement accompanied by early rehabilitation. METHODS： Outcomes of 28 knee osteoarthritis patients （46 knees） who were treated by joint replacement from 2005 June to August were retrospectively analyzed. Sixteen patients were served as experimental group, including 4 males and 12 females, aged 59-77 （65.3＋5.3） years, and the course of disease was 10-15 （13.4＋4.3） years. These patients were received mini-incision knee replacement, accompanied by specified early rehabilitation procedure. Early rehabilitation procedure comprised psychological treatment, training before knee replacement, muscle strength training after knee replacement, and correction of poor gait, joint position sense training and exercise for coordination after knee replacement, early quadriceps femoral muscle active extension knee exercises especially emphasized. Another 12 patients were served as control group, including 5 males and 7 females, aged 60 75 （67.5＋4.7） years, with course of disease 8-18 （12.8＋4.9） years, they were received normal knee replacement. Pain severity, joint motion ranges and functional situations were evaluated. RESULTS： Twenty-eight patients stayed in hospital for （13.2＋2.7） days （ranging from 10 days to 16 days）. All the patients were followed up 9 to 12 months. There were no significantly differences in pain severity, joint motion ranges and functional scores on admission between two groups. Pain, joint motion and joint functions were improved greatly after knee replacement. The joint motion ranges and functional scores were higher on discharge and the last follow-up in the experimental group than that of the control group. CONCLUSION： The program that consists of Mini-incision knee replacement, which protected quadricep muscle intactness and diminished surgical injury, accompanied by psychological treatment, preoperational preparation, postoperational training, correction of

关 键 词：膝关节置换 康复训练 心理指导 

分 类 号：R318[医药卫生—生物医学工程]