常规康复附加胸椎灵活性训练在肩袖损伤患者术后康复中的应用效果  

Application effectiveness of conventional rehabilitation combined with thoracic spine mobility exercises in postoperative rehabilitation of patients with rotator cuff injury

作　　者：龚嘉玉 张翠文 王华军[2] 钱玉秀[3] 侯辉歌[2] 严加洁[2] 郑小飞 Gong Jiayu;Zhang Cuiwen;Wang Huajun;Qian Yuxiu;Hou Huige;Yan Jiajie;Zheng Xiaofei(School of Nursing,Jinan University,Guangzhou 510630,China;Bone Joint and Sports Medicine Center,First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Operating Room,First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学护理学院,广州510630 [2]暨南大学附属第一医院骨关节与运动医学中心,广州510630 [3]暨南大学附属第一医院手术室,广州510630

出　　处：《中华创伤杂志》2023年第11期1022-1028,共7页Chinese Journal of Trauma

摘　　要：目的比较常规康复附加胸椎灵活性训练与常规康复在肩袖损伤患者术后康复中的应用效果。方法采用回顾性队列研究分析2019年2月至2022年2月暨南大学附属第一医院收治的204例肩袖损伤患者的临床资料,其中男88例,女116例;年龄18~87岁[(54.1±11.8)岁]。均行初次单侧关节镜下肩袖修补术。98例采用常规康复治疗(常规康复组),106例在常规康复的基础上附加胸椎灵活性训练(附加训练康复组)。比较两组术前及术后1、3、6个月视觉模拟评分(VAS)、Constant肩关节评分、美国加州大学洛杉矶分校(UCLA)肩关节评分、肩关节活动度(前屈、外展、外旋)。观察康复训练后两组并发症发生情况。结果患者均获随访6~18个月[(8.4±3.5)个月]。两组术后1、3、6个月VAS、Constant肩关节评分、UCLA肩关节评分和肩关节活动度较术前明显改善(P均<0.01)。术前及术后1、3、6个月两组间VAS差异无统计学意义(P均>0.05)。术后3、6个月附加训练康复组Constant肩关节评分分别为(77.7±5.8)分、(88.4±7.7)分,高于常规康复组的(73.7±6.6)分、(85.5±4.9)分(P均<0.01),术前及术后1个月两组间差异无统计学意义(P均>0.05)。术后3个月附加训练康复组UCLA肩关节评分为(25.5±3.7)分,高于常规康复组的(21.8±5.6)分(P<0.01),术前及术后1、6个月两组间差异无统计学意义(P均>0.05)。术后3、6个月附加训练康复组前屈角度为(135.5±12.8)°、(165.1±11.3)°,高于常规康复组的(129.3±12.3)°、(151.1±11.2)°;外展角度为(102.3±12.9)°、(130.4±15.1)°,高于常规康复组的(93.2±11.0)°、(123.5±13.7)°;外旋角度为(57.2±13.1)°、(72.3±12.3)°,高于常规康复组的(46.4±8.8)°,(67.4±14.1)°(P均<0.01)。术前及术后1个月两组间前屈、外展及外旋角度差异无统计学意义(P均>0.05)。术后6个月常规康复组发生肩袖再撕裂1例(1.0%),附加训练康复组2例(1.9%);常规康复组发生肩关节粘连5例(5.Objective To compare the application effectiveness of conventional rehabilitation combined with thoracic spine mobility exercises and conventional rehabilitation in postoperative rehabilitation of patients with rotator cuff injury.Methods A retrospective cohort study was conducted to analyze the clinical data of 204 patients with rotator cuff injury admitted to First Affiliated Hospital of Jinan University from February 2019 to February 2022,including 88 males and 116 females;aged 18‑87 years[(54.1±11.8)years].Initial unilateral arthroscopic rotator cuff repair was performed on all the patients.A total of 98 patients received a conventional rehabilitation plan(conventional rehabilitation group),and 106 patients received additional thoracic spine mobility exercises as well as conventional rehabilitation(additional exercise rehabilitation group).The visual analog scale(VAS),Constant shoulder joint score,University of California at Los Angeles(UCLA)shoulder joint score,and shoulder range of motion(forward flexion,abduction,and external rotation)before surgery and at 1,3,and 6 months after surgery were compared between the two groups.The occurrence of complications after rehabilitation was observed.Results All the patients were followed up for 6‑18 months[(8.4±3.5)months].The VAS score,Constant shoulder joint score,UCLA shoulder joint score,and shoulder joint range of motion of both groups were improved significantly at 1,3,and 6 months after surgery compared with those before surgery(all P<0.01).There was no statistically significant difference in VAS score between the two groups before surgery and at 1,3,and 6 months after surgery respectively(all P>0.05).At 3 and 6 months after surgery,the values of the Constant shoulder joint score of the additional exercise rehabilitation group were(77.7±5.8)points and(88.4±7.7)points respectively,which were higher than those of the conventional rehabilitation group[(73.7±6.6)points and(85.5±4.9)points](all P<0.01).There was no statistically significant difference in t

关 键 词：肩关节 康复 关节镜检查 

分 类 号：R473.6[医药卫生—护理学]