低强度聚焦超声波结合运动治疗髌骨软化症的临床疗效  

Clinical Effect of Low-intensity Focused Ultrasound Combined with Exercise Therapy on Chondromalacia Patellae

作　　者：张娟[1] 王懿[2] 周谋望[1] 李筱雯[1] ZHANG Juan;WANG Yi;ZHOU Mouwang;LI Xiaowen(Rehabilitation Department,Peking University Third Hospital,Beijing 100191,China;Institute of Sports Medicine,Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院康复医学科,北京100191 [2]北京大学运动医学研究所,北京100191

出　　处：《首都体育学院学报》2020年第4期379-384,共6页Journal of Capital University of Physical Education and Sports

摘　　要：研究目的:明确低强度聚焦超声波结合运动治疗髌骨软化症的临床疗效。选择2018年7-12月在北京大学第三医院康复科门诊就诊患者60例,按就诊时间顺序入组,均分为3组。治疗方法:1)常规组:使用常规理疗中的超声波治疗于患处,为期4周;2)治疗组:使用低强度聚焦超声波治疗于患处,为期4周;3)结合运动治疗组:使用低强度聚焦超声波治疗于患处,并同时结合运动康复治疗,为期4周。分别在患者治疗前、疗程中期、疗程结束后当天、疗程结束后15 d、疗程结束后30 d对各组患者患侧膝关节进行NRS评分和Lysholm评分,并统计疗程结束后15 d和治疗结束后30 d的随访数据来评价远期疗效。研究结果:3组患者在疗程结束后当天的NRS评分与Lysholm评分均显著优于治疗前,差异均有统计学意义(P<0.05);治疗组和结合运动治疗组的患者在疗程中期的NRS评分与Lysholm评分均显著优于常规组,差异均有统计学意义(P<0.05);结合运动治疗组患者在疗程结束后15 d的总有效率为90%、在疗程结束后3 0 d的总有效率为85%,组间差异有统计学意义(P<0.05)。3种治疗方法在疗程结束时均有效,低强度聚焦超声波结合运动治疗后总有效率有所提高,并具有显著性差异。研究结论:低强度聚焦超声波由于解决了治疗剂量和"治疗头"贴合度及治疗深度的问题,所以快速达到了治疗效果,对于临床来说,更快地缓解了患者的疼痛。静力性直抬腿练习、靠墙静蹲练习、夹球训练、推髌练习符合髌骨软化症患者的运动强度。低强度聚焦超声波结合运动治疗可增加膝关节的稳定性,比单一使用超声波进行治疗的常规组和治疗组产生了更好的治疗效果。在髌骨软化症的临床治疗中,要充分重视与运动疗法的结合。Objective: To determine the clinical effect of low-intensity focused ultrasound(LFU)combined with exercise therapy on chondromalacia patellae. From July to December 2018, 60 outpatients in the Department of Rehabilitation, Third Hospital of Peking University were selected and divided into three groups according to the order of visiting time. Treatment: 1)Conventional group: use the ultrasonic therapy of conventional physical therapy on the affected part, for 4 weeks;2)Treatment Group: The affected part was treated with low intensity focused ultrasound for 4 weeks;3)exercise therapy group: use low-intensity focused ultrasound to treat the affected part, and at the same time cooperate with exercise rehabilitation, for 4 weeks. The NRS pain score and Lysholm score were evaluated before treatment, in the middle of treatment, after treatment, 15 days after treatment and 30 days after the treatment. The long-term efficacy was evaluated by the follow-up data of 15 days and 30 days after the treatment. Results: The NRS score and Lysholm score of the three groups on the day after the end of treatment were significantly better than those before treatment, and the differences were statistically significant(P<0.05);the NRS score and Lysholm score of the treatment group and the combined exercise treatment group at the middle of the course were significantly better than those of the conventional group, and the differences were statistically significant(P<0.05);the total effective rate of combined exercise therapy group was 90% on the 15 th day and 85% on the 30 th day after the end of the course of treatment(P<0.05). All three treatments were effective at the end of the course, where the total effective rate of low intensity focused ultrasound combined with exercise therapy was improved, and the difference was significant.Conclusion: Low intensity focused ultrasound solves the problems of treatment dose, fitting degree of"treatment head"and treatment depth, so it can achieve treatment effect quickly, and relieve the pain of pa

关 键 词：低强度聚焦超声波 运动疗法 髌骨软化症 临床疗效 

分 类 号：G804.5[文化科学—运动人体科学]