【摘要】：[目的]探討全膝關(guān)節(jié)置換術(shù)后患者對(duì)被動(dòng)與主動(dòng)活動(dòng)康復(fù)鍛煉方式的心理接受程度及心理狀態(tài)差異,并分析其對(duì)功能恢復(fù)的影響。[方法]本院2008年4月~2012年4月收治的單側(cè)膝關(guān)節(jié)骨性關(guān)節(jié)炎患者151例,均采用單側(cè)膝關(guān)節(jié)置換術(shù);隨機(jī)分為持續(xù)被動(dòng)運(yùn)動(dòng)組(continuous passive motion,CPM)和自主訓(xùn)練組(active motion,AM)。比較兩組患者年齡、性別、體重指數(shù)、手術(shù)時(shí)間、術(shù)后引流量、住院時(shí)間、對(duì)康復(fù)鍛煉接受程度、美國(guó)特種外科醫(yī)院膝關(guān)節(jié)評(píng)分(hospital for special surgery,HSS)、關(guān)節(jié)活動(dòng)度、醫(yī)院焦慮抑郁表(hospital anxiety and depression scale,HADS)等。[結(jié)果]兩組在年齡、性別、體重指數(shù)、手術(shù)時(shí)間、術(shù)后引流量的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。CPM組平均住院時(shí)間為(5.25±0.98)d,AM組為(4.36±0.59)d,AM組平均住院時(shí)間比CPM組少(0.89±0.41)d,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。CPM組中64%患者表示對(duì)CPM恐懼或勉強(qiáng)接受,而在AM組僅為32%(P0.05)。CPM組平均HADS評(píng)分(9.40±3.70)分,而AM組平均HADS評(píng)分(6.20±3.10)分,AM組比CPM組少(3.20±0.70)分,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。此外,AM組可明顯緩解術(shù)后早期疼痛及腫脹指數(shù),改善HSS評(píng)分及關(guān)節(jié)活動(dòng)度(P0.05),但遠(yuǎn)期效果差異無統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]"自主訓(xùn)練,護(hù)理輔助"的康復(fù)策略更容易被患者所接受,能早期改善關(guān)節(jié)功能、緩解局部腫脹及疼痛,是TKA術(shù)后早期功能康復(fù)訓(xùn)練的方法之一。
[Abstract]:[objective] to explore the degree of psychological acceptance and mental state difference between passive and active rehabilitation exercises after total knee arthroplasty, and to analyze its influence on functional recovery. [methods] from April 2008 to April 2012, 151 patients with unilateral knee osteoarthritis were treated with unilateral knee arthroplasty, and were randomly divided into two groups: continuous passive exercise group (continuous passive motility group) and autonomous training group (active motionAM). Age, sex, body mass index (BMI), operation time, postoperative drainage, hospitalization time, acceptance of rehabilitation exercise, knee joint score (hospital for special Surgery-HSS), and joint motion were compared between the two groups. Hospital anxiety and depression table (hospital anxiety and depression scaleHads, et al. [results] Age, sex, body mass index, operation time, There was no significant difference in postoperative drainage volume between the two groups (P0.05). The average hospitalization time of CPM group was (5.25 鹵0.98) days. The average hospitalization time of CPM group was (4.36 鹵0.59) days less than that of CPM group (0.89 鹵0.41) days. The difference between the two groups was statistically significant (P0.05). 64% of the patients in CPM group expressed fear or reluctantly accepting CPM. However, the average HADS score in AM group was only 32% (P0.05). The average HADS score in AM group was (6.20 鹵3.10) points lower than that in CPM group (3.20 鹵0.70). There was significant difference between the two groups (P0.05). In addition, early postoperative pain and swelling index, HSS score and joint motion were significantly alleviated in AM group (P0.05), but there was no significant difference in long-term effect (P0.05). [conclusion] the rehabilitation strategy of "independent training and nursing assistance" is more easily accepted by patients, it can improve joint function early, relieve local swelling and pain. It is one of the methods of early functional rehabilitation training after TKA.
【作者單位】： 河南安陽(yáng)市人民醫(yī)院骨一科;
【分類號(hào)】：R473.6

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本文編號(hào)：2149955