医共体成员单位康复治疗对全膝关节置换术患者术后康复的影响  

Influence of rehabilitation therapy in medical community member units on functional rehabilitation,rehabilitation time and complication rate in patients with TKA

作　　者：张旭元 王银海 李亮 王鹏[2] ZHANG Xuyuan;WANG Yinhai;LI Liang;WANG Peng(Department of Orthopedics,Changxing District of the Second Affiliated Hospital of Zhejiang University School of Medicine(Changxing County People's Hospital),Changxing 313100,China;不详)

机构地区：[1]浙江大学医学院附属第二医院长兴院区(长兴县人民医院)骨科,313100 [2]浙江大学医学院附属第二医院长兴院区(长兴县人民医院)康复科,313100

出　　处：《浙江医学》2023年第7期732-736,共5页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(GF20H060018)。

摘　　要：目的探讨医共体成员单位康复治疗对全膝关节置换术(TKA)患者功能康复、康复时间及并发症发生率的影响。方法选取2020年1月至2022年1月在浙江大学医学院附属第二医院长兴院区骨科行TKA的60例患者作为研究对象。所有患者均在医共体总院内接受骨康一体化早期康复,达到出院标准后,按随机数字表法分为常规组30例和下转组30例。常规组出院后采用居家自行康复的方法,下转组在医共体成员单位进行康复。比较两组患者的疼痛程度、膝关节功能恢复、康复时间及并发症发生率。结果与干预前比较,干预1、2、3个月后,两组患者视觉模拟评分均逐渐降低,且下转组始终低于常规组(均P<0.05)。与干预前比较,干预1、2、3个月后两组患者疼痛、行走功能、关节活动程度、肌力、屈曲畸形、稳定性、总分等评分均逐渐升高,且下转组始终高于常规组,差异均有统计学意义(均P<0.01)。下转组患者屈曲度恢复到80°、100°、120°时的康复时间均少于常规组,差异均有统计学意义(均P<0.01)。康复治疗期间,下转组的并发症发生率为9.99%,低于常规组的33.34%,差异有统计学意义(P<0.05)。结论医共体成员单位的康复治疗能够减轻TKA患者疼痛程度,改善患者膝关节功能,缩短患者康复时间及减少患者并发症发生率,具有较好的临床应用价值,因此,医共体成员单位康复治疗模式值得广泛推广和应用。Objective To evaluate the efficacy of rehabilitation therapy for patients receiving total knee arthroplasty(TKA)in medical community member units.Methods Sixty patients who underwent TKA in Department of Orthopedics of Changxing County People's Hospital from January 2020 to January 2022 were enrolled.All patients received integrated early rehabilitation in the general hospital of the medical community.After discharge patients were randomly divided into two groups with 30 cases in each group,the control group receive conventional rehabilitation at home and the study group was transferred to the medical community member unit for rehabilitation.The visual analogue scale(VAS)score,functional recovery,recovery time and complications were compared between the two groups.Results After 1,2 and 3 months of rehabilitation,the VAS scores decreased in both groups,and the scores in the study group was always lower than that in the control group(all P<0.05).The walking function,joint activity,muscle strength,flexion deformity and stability were improved after rehabilitation in both groups,and the above indicators in the study group were all better than those in the control group(all P<0.01).The recovery time for flexion degree to 80°,100°,and 120°in the study group was shorter than that in the control group(all P<0.01).The complication rate during rehabilitation period in the study group was lower than that in the control group(9.99%vs.33.34%,P<0.05).Conclusion The rehabilitation therapy in the member units of the medical community for patients after TKA has better efficacy in relieving pain,improving the knee joint function,shortening the rehabilitation time and reducing the incidence of complications,compared to home rehabilitation.

关 键 词：医共体 康复治疗 全膝关节置换 功能康复 康复时间 并发症发生率 

分 类 号：R687.3[医药卫生—骨科学]