本文選題：膝關(guān)節(jié)手術(shù) + 膝關(guān)節(jié)骨性關(guān)節(jié)炎��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討膝關(guān)節(jié)表面置換術(shù)(Total Knee Arthroplasty,TKA)術(shù)后進行早期閉鏈式功能鍛煉的臨床意義。方法:前瞻性分析2015年11月至2016年10月于我院治療并符合納入標準的膝關(guān)節(jié)表面置換術(shù)術(shù)后患者60例�；颊唠S機分為早期閉鏈功能鍛煉組(試驗組)30例和對照組30例。試驗組術(shù)后即行踝泵運動、手術(shù)24h之后行屈膝屈髖鍛煉、手術(shù)72h之后行直立屈膝功能鍛煉、手術(shù)后1周行類似踩平衡板運動、手術(shù)3周之后行單腿直立屈曲鍛煉。對照組患者手術(shù)即行踝泵運動,手術(shù)24h之后行直腿抬高鍛煉、手術(shù)72h之后行壓腿功能鍛煉、手術(shù)1周之后行床邊屈膝鍛煉。對比試驗組患者與對照組患者術(shù)前、術(shù)后1周、術(shù)后3周、術(shù)后6周及術(shù)后3個月的美國特種醫(yī)院的評分系統(tǒng)(Hospital for Special Surgery,HSS)、術(shù)前及術(shù)后第2、3個月后視覺模擬評分(Visual Analogue Scale,VAS),統(tǒng)計兩組患者并發(fā)癥發(fā)生情況。結(jié)果:術(shù)前兩組患者的年齡、性別、手術(shù)節(jié)段、體重指數(shù)、HSS、VAS評分無明顯差異(P0.05)。所有患者均獲得隨訪。試驗組2名患者未按規(guī)定鍛煉、對照組3名患者未按規(guī)定鍛煉予以剔除。兩組患者術(shù)后HSS評分與術(shù)前比均顯著改善(P0.05),術(shù)后1周、術(shù)后3周、術(shù)后6周以及術(shù)后3個月試驗組患者的HSS評分優(yōu)于對照組(P0.05)。兩組患者術(shù)后VAS評分與術(shù)前比均顯著改善(P0.005),術(shù)后第2個月試驗組患者VAS評分優(yōu)于對照組(P0.05),而術(shù)后3個月兩組患者間的HSS評分結(jié)果差異無統(tǒng)計學(xué)意義(P=0.353)。對照組1例患者出現(xiàn)切口愈合不良,予持續(xù)換藥觀察,對滲出做培養(yǎng),并且做出相關(guān)處理后予以剔除,余患者術(shù)后均未發(fā)生下肢深靜脈血栓、感染等并發(fā)癥。結(jié)論:膝關(guān)節(jié)表面置換術(shù)術(shù)后患者進行早期閉鏈式功能鍛練能促進其早期康復(fù)、提高療效,并且是安全可行的。
[Abstract]:Objective: to investigate the clinical significance of early closed chain exercise after total knee arthroplasty. Methods: from November 2015 to October 2016, 60 patients who were treated in our hospital and met the standard of knee arthroplasty were analyzed prospectively. Patients were randomly divided into early closed chain function exercise group (30 cases in the experimental group and 30 cases in the control group). In the experimental group, ankle pump exercise was performed immediately after operation, knee flexion and hip flexion exercise was performed 24 hours after operation, orthostatic flexion function exercise was performed 72 hours after operation, similar balance plate exercise was performed 1 week after operation, and one leg upright flexion exercise was performed 3 weeks after operation. The patients in the control group underwent ankle pump exercise 24 hours after operation straight leg elevation exercise 72 hours after operation and knee bending exercise at the bedside after 1 week operation. The patients in the trial group were compared with those in the control group before operation, 1 week after operation and 3 weeks after operation. Six weeks after operation and three months after operation, the scoring system of for Special SurgeryHSS in American Special Hospitals was used. Visual Analogue scale and visual analogue scale were evaluated before and 2 and 3 months after operation. The complications of the two groups were calculated. Results: there was no significant difference in age, sex, operative segment, body mass index (BMI) and VAS score between the two groups (P 0.05). All patients were followed up. Two patients in the test group did not exercise as required, and three patients in the control group were excluded. The HSS scores of the two groups were significantly improved than those of the control group. The HSS scores in the trial group were significantly better than those in the control group at 1 week, 3 weeks, 6 weeks and 3 months after operation. The VAS scores in the two groups were significantly improved compared with those before operation (P 0.005). The VAS scores in the test group were better than those in the control group (P 0.05) at the 2nd month after operation, but there was no significant difference in HSS score between the two groups at 3 months after operation. In the control group, one patient had bad wound healing and was observed by continuous dressing change. The exudation was cultured and removed after treatment. No complications such as deep vein thrombosis and infection occurred in the remaining patients after operation. Conclusion: it is safe and feasible for the patients after knee surface replacement to carry out early closed chain exercise to promote their early recovery and improve the curative effect.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.6

【參考文獻】

相關(guān)期刊論文 前10條

1 陳旭;;快速康復(fù)鍛煉對全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動度的影響[J];河南外科學(xué)雜志;2016年04期

2 姜義琴;;全膝關(guān)節(jié)置換術(shù)后手術(shù)自行鍛煉與CPM鍛煉對膝關(guān)節(jié)功能的影響[J];中國衛(wèi)生標準管理;2015年08期

3 黃勇;王鑫靈;;TKA術(shù)后醫(yī)生指導(dǎo)下患者自主化康復(fù)訓(xùn)練與CPM機訓(xùn)練的早期療效比較[J];實用醫(yī)學(xué)雜志;2015年07期

4 黃若葭;武俊英;許志強;劉鴻宇;;懸吊下進階式閉鏈運動療法對膝關(guān)節(jié)骨性關(guān)節(jié)炎患者平衡能力的影響[J];體育科學(xué);2015年02期

5 李宗需;;CPM機在骨科術(shù)后關(guān)節(jié)功能鍛煉中的應(yīng)用價值[J];實用臨床醫(yī)學(xué);2014年11期

6 徐麗麗;萬永鮮;胥方元;;早期CPM鍛煉對初次全膝關(guān)節(jié)置換術(shù)后隱性失血量的影響[J];瀘州醫(yī)學(xué)院學(xué)報;2014年03期

7 孫瑞波;樊麗霞;劉又文;;中藥熏洗及針灸配合股四頭肌鍛煉治療膝關(guān)節(jié)骨性關(guān)節(jié)炎療效觀察[J];中醫(yī)臨床研究;2014年13期

8 盧敏;張申堯;;股四頭肌功能鍛煉在膝骨性關(guān)節(jié)炎治療中的作用[J];中國中醫(yī)骨傷科雜志;2012年12期

9 龐勇;徐志宏;史冬泉;陳東陽;蔣青;;類風濕關(guān)節(jié)炎膝關(guān)節(jié)置換后深靜脈血栓發(fā)生情況及溶栓效果研究Δ[J];中國矯形外科雜志;2012年13期

10 焦玉爽;秦長杰;;骨科深靜脈血栓形成預(yù)防研究概況[J];實用心腦肺血管病雜志;2012年03期

，

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