正念训练配合早期强化功能锻炼对胫骨平台骨折患者负性情绪和膝关节功能的影响  

The effect of mindfulness training combined with early strengthening exercise on negative emotion and knee function in patients with tibial plateau fracture

作　　者：张蕾[1] 张睿[1] 薛建良 何成奇[1] ZHANG Lei;ZHANG Rui;XUE Jian-liang;HE Cheng-qi(Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院康复医学科,成都610041

出　　处：《东南国防医药》2021年第4期350-354,共5页Military Medical Journal of Southeast China

基　　金：四川省科学技术厅项目(2019YJ0130);成都市科技项目(2019-YF05-00467-SN)。

摘　　要：目的探讨正念训练配合早期强化功能锻炼对胫骨平台骨折患者负性情绪和膝关节功能的影响。方法选择2019年1月到2020年6月华西医院康复医学科治疗的96例胫骨平台骨折患者作为研究对象,根据治疗方式的不同(胫骨骨折治疗方式相同,术后进行康复的方式不同),按随机数字表法划分为联合组、对照组。对照组的患者仅采取康复手段进行治疗;联合组患者则在康复治疗的基础上,增加正念训练,包括正念减压、正念练习、情绪行为引导。采用休斯顿疼痛情况调查表(HPOI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)及Lysholm评分进行对比,分析正念训练配合早期强化功能锻炼对胫骨平台骨折患者疼痛感、抑郁或焦虑等不良情绪,以及膝关节功能等方面的影响。结果联合组患者较对照组疼痛度显著降低(P<0.05),术后3个月胫骨功能优良率显著提高(87.5%vs 68.8%,P<0.05),SAS、SDS评分显著降低[(28.14±5.75)分vs(32.71±7.23)分,(37.23±6.93)分vs(40.67±8.46)分,P<0.05],Lysholm评分显著降低(P<0.05)。结论对胫骨平台骨折的患者在切开复位内固定的康复阶段,采取正念训练配合早期强化功能锻炼,不仅可以缓解患者抑郁与焦虑的负性情绪,并在一定程度上减轻疼痛感,并加快膝关节功能的恢复,故可积极推广应用。Objective The effects of mindfulness training combined with early functional strengthening exercise on negative emotions and knee function in patients with tibial plateau fracturewere investigated in this paper.Methods A total of 96 patients with tibial plateau fracture treated in the Rehabilitation Department of West China Hospital from January 2019 to June 2020 were selected as the research objects.According to the different treatment methods(the treatment methods of the two groups were the same,and the rehabilitation methods were different 24h after surgery),they were randomly divided into two groups,namely the combined group and the control group.Patients in the control group were only treated by rehabilitation means.Patients in the combination group received mindfulness training in addition to rehabilitation therapy.Houston Pain Inventory(HPOI),Self-Rating Anxiety Inventory(SAS),Self-Rating Depression Inventory(SDS)and Lysholm score were used to compare and analyze the effects of mindfulness training combined with early strengthening functional exercise on pain,depression or anxiety and other adverse emotions,as well as knee function in patients with tibial plateau fracture.Results Compared with the control group,the pain degree was significantly reduced(P<0.05),the rate of tibial function was significantly increased(87.5%vs 68.8%,P<0.05),anxiety and depression were relieved[(28.14±5.75)vs(32.71±7.23),(37.23±6.93)vs(40.67±8.46),P<0.05],and Lysholm score was significantly reduced in the combined group(P<0.05).Conclusion For patients with tibial plateau fracture in the recovery stage of open reduction and internal fixation,mindfulness training combined with early functional strengthening exercise can relieve the negative emotions of depression and anxiety,relieve pain to a certain extent,and speed up the recovery of knee function,which can be actively promoted and applied.

关 键 词：胫骨平台骨折 正念训练 焦虑 抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学]