前交叉韧带重建术后股四头肌萎缩的研究进展  

Research Progress of Quadriceps Atrophy After Anterior Cruciate Ligament Reconstruction

作　　者：王元新 薛爱荣[3] 闫磊 尚芳如 刘涛 WANG Yuanxin;XUE Airong;YAN Lei;SHANG Fangru;LIU Tao(Department of Medical Sports,Henan No.3 Provincial People’s Hospital,Zhengzhou 450000,China;Department of Orthopedics,Henan No.3 Provincial People’s Hospital,Zhengzhou 450000,China;Department of Rehabilitation,Affiliated Hospital of Henan Academy of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院医学运动科,河南郑州450000 [2]河南省直第三人民医院骨科,河南郑州450000 [3]河南省中医药研究院附属医院康复科,河南郑州450000

出　　处：《河南医学研究》2022年第20期3835-3840,共6页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200235)。

摘　　要：前交叉韧带(ACL)撕裂多见于运动中突然减速、变向、外来暴力及各种外伤等。ACL完全断裂的治疗首选膝关节镜下ACL重建术(ACLR)。但是ACLR术后往往会出现下肢肌力萎缩,尤其是股四头肌萎缩。目前,针对ACLR后股四头肌萎缩原因、评估手段和康复措施等的相关研究较少。本文通过查阅大量文献,总结ACLR术后股四头肌萎缩的原因主要包括神经肌肉控制、中枢抑制及术前、术后因素;评估方法主要包括周径测量、肌骨超声、核磁共振及经颅磁测试;康复策略包括术前预康复、支具运用及负重时机、术后康复,其中术后康复中血流抑制训练、神经肌肉控制训练及电刺激是重点康复方向。最后简要综述了中医传统疗法、心理康复对ACLR后股四头肌萎缩的研究,为ACLR术后治疗提供理论参考。Anterior cruciate ligament(ACL)tears are common in sudden deceleration,disorientation,external violence and various traumas during movement.Treatment of complete ACL rupture is preferred for knee arthroscopic ACL reconstruction(ACLR).However,atrophy of the lower extremities,especially the quadriceps muscle atrophy often occurs after ACLR.At present,there are few studies on the causes,assessment methods and rehabilitation measures of the post-ACLR quadriceps atrophy.By consulting a large number of literature,the article summarize that the causes of quadriceps atrophy after ACLR surgery mainly include central inhibition,neuromuscular control,and preoperative and postoperative factors.Assessment methods mainly include circumference measurement,myoskeletal ultrasound,MRI and transcranial magnetic test.Rehabilitation strategies include preoperative rehabilitation,brace use and timing of weight bearing and postoperative rehabilitation,of which blood flow suppression training,neuromuscular control training and electrical stimulation are the key rehabilitation directions in postoperative rehabilitation.Finally,a brief review of the research on quadriceps atrophy after ACLR is briefly reviewed by traditional Chinese medicine therapy and psychological rehabilitation,which provides a theoretical reference for the postoperative treatment of ACLR.

关 键 词：前交叉韧带 前交叉韧带重建术 股四头肌萎缩 康复进展 

分 类 号：R658.3[医药卫生—外科学]