慢性半月板损伤关节镜手术后阶段性动力链训练的疗效分析  

Efficacy of staged kinetic chain rehabilitation after arthroscopic surgery for knee chronic meniscal injury

作　　者：田杨 赵紫薇 TIAN Yang;ZHAO Ziwei(Department of Rehabilitation Medicine,General Hospital of Northern Theater Command,Shenyang 110003,China)

机构地区：[1]中国人民解放军北部战区总医院康复医学科,沈阳110003

出　　处：《中国医科大学学报》2025年第4期364-368,共5页Journal of China Medical University

基　　金：辽宁省科学技术计划(2022JH2/101500031)。

摘　　要：目的设计并实施阶段性动力链训练康复(SKCR)计划,对慢性半月板损伤关节镜手术后的行SKCR患者进行临床疗效分析,以阐明心理干预与物理治疗对此类患者临床康复的重要性。方法选择2019年5月至2023年3月期间我院慢性半月板损伤关节镜手术后的100例患者,分为对照组(术后常规训练康复,n=50)和SKCR组(术后SKCR,n=50)。采用Lysholm评价系统、SF-36评价系统和MCMQ评价系统,对2组患者进行疗效分析。结果SKCR组Lysholm评分(89.50±8.09)显著高于对照组(69.34±11.97,P<0.05)。SF-36评价结果显示,SKCR组的生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、社会功能(SF)、情感职能(RE)和精神健康(MH)评分均显著高于对照组(P<0.05),但SKCR组总体健康(GH)和活力(VT)与对照组比较差异无统计学意义(P>0.05)。MCMQ评价结果显示,SKCR组的面对维度评分(20.80±3.12)显著高于对照组(18.14±4.42),而对照组回避维度和屈服维度评分显著高于SKCR组,差异有统计学意义(P<0.05);相关性分析发现,SKCR组Lysholm评分、SF-36评价系统RP、BP、GH、RE、VT、MH评分与MCMQ的面对维度呈正相关(P<0.05),对照组Lysholm评分、SF-36评价系统PF、BP、GH、SF、RE、MH评分与MCMQ的屈服维度呈负相关(P<0.05)。结论半月板损伤关节镜手术后接受SKCR治疗的患者膝关节功能和生活质量明显改善,且SKCR临床疗效明显优于常规康复治疗。半月板损伤关节镜手术后患者需要心理治疗,以降低负面的应对策略对身体状况和生活质量的影响。Objective To assess the clinical efficacy of postoperative staged kinetic chain rehabilitation(SKCR)in patients with knee chronic meniscal injury undergoing arthroscopic surgery.Methods This study included 100 patients with chronic meniscal injury who underwent arthroscopic surgery between May 2019 and March 2023.There were 50 patients each in the regular knee rehabilitation(control)and SKCR groups.The patients completed sociodemographic questionnaires,including the Lysholm knee joint scoring scale,SF-36 health survey,and medical coping modes questionnaire(MCMQ).Results The Lysholm knee joint score for patients in the SKCR group was significantly higher than routine postoperative rehabilitation group(89.50±8.09 vs.69.34±11.97,P<0.05).The total knee joint score was significantly higher in the SKCR group compared to that in the control group(P<0.05).Notably,all subscales of the SF-36 evaluation,except general health and witality,showed significant improvements(P<0.05).In addition,the MCMQ score analysis revealed a significantly higher score for the facing strategy of the SKCR group compared to that of the control group(20.80±3.12 vs.18.14±4.42,P<0.05).Conversely,the control group showed significantly higher scores for avoidance and acceptance-resignation strategies(P<0.05).Further correlation analysis showed a positive correlation between the Lysholm and SF-36 scores with the facing component of the MCMQ scale in the SKCR group,whereas a negative correlation was observed with the acceptance-resignation component in the conventional rehabilitation group.Conclusion Compared to conventional rehabilitation treatment,SKCR can improve knee function,quality of life,and clinical efficacy after arthroscopic meniscal surgery more significantly,highlighting the importance of postoperative psychological interventions for enhancing patient well-being.

关 键 词：半月板损伤 关节镜手术 阶段性动力链训练 生活质量 

分 类 号：R493[医药卫生—康复医学]