中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2012年
9期
681-684
,共4页
郑光新%赵晓鸥%李雯%张玉静
鄭光新%趙曉鷗%李雯%張玉靜
정광신%조효구%리문%장옥정
康复%关节置换术%膝关节
康複%關節置換術%膝關節
강복%관절치환술%슬관절
Rehabilitation%Arthroplasty%Knees joint
目的 观察双侧全膝关节置换术(TKA)与单侧TKA术后早期专业康复治疗的疗效.方法 采用对比研究法将68例TKA患者分为单侧组(36例)及双侧组(32例).所有患者TKA术后均接受相同康复治疗,术后平均住院康复时间为(15.0±3.7)d.于出院时采用疼痛VAS评分、膝关节活动度(ROM)及膝关节损伤和骨性关节炎评定量表( KOOS)对2组患者膝关节功能进行评定,术后(10.52 ±4.41)个月随访时采用KOOS评分及美国膝关节协会量表(KSS)对2组患者远期膝关节恢复情况进行评定.结果 出院时,双侧组和单侧组疼痛VAS评分分别为(16.89±5.17)分和(17.80±10.95)分,伸膝不足分别为(1.88±2.61)°和(2.57±2.61)°,置换膝主动ROM分别为(102.89±14.35)°和(106.26±13.03)°,KOOS评分分别为(67.63 ±11.82)分和(67.52 ±12.07)分,2组间差异均无统计学意义(P＞0.05).随访时发现双侧组及单侧组KOOS评分分别为(96.11±2.31)分和(95.41±3.12)分,均较出院时明显提高(P＜0.05);此时2组患者KOOS和KSS-I评分组间差异均无统计学意义(P＞0.05),双侧组KSS-Ⅱ评分[(89.06±9.63)分]较单侧组[(83.33±11.46)分]显著增高,组间差异具有统计学意义(P＜0.05).结论 双侧TKA术后患者经早期系统康复治疗能获得与单侧TKA患者同样良好的治疗效果,并且其远期膝关节活动功能恢复情况明显优于单侧TKA患者.
目的 觀察雙側全膝關節置換術(TKA)與單側TKA術後早期專業康複治療的療效.方法 採用對比研究法將68例TKA患者分為單側組(36例)及雙側組(32例).所有患者TKA術後均接受相同康複治療,術後平均住院康複時間為(15.0±3.7)d.于齣院時採用疼痛VAS評分、膝關節活動度(ROM)及膝關節損傷和骨性關節炎評定量錶( KOOS)對2組患者膝關節功能進行評定,術後(10.52 ±4.41)箇月隨訪時採用KOOS評分及美國膝關節協會量錶(KSS)對2組患者遠期膝關節恢複情況進行評定.結果 齣院時,雙側組和單側組疼痛VAS評分分彆為(16.89±5.17)分和(17.80±10.95)分,伸膝不足分彆為(1.88±2.61)°和(2.57±2.61)°,置換膝主動ROM分彆為(102.89±14.35)°和(106.26±13.03)°,KOOS評分分彆為(67.63 ±11.82)分和(67.52 ±12.07)分,2組間差異均無統計學意義(P＞0.05).隨訪時髮現雙側組及單側組KOOS評分分彆為(96.11±2.31)分和(95.41±3.12)分,均較齣院時明顯提高(P＜0.05);此時2組患者KOOS和KSS-I評分組間差異均無統計學意義(P＞0.05),雙側組KSS-Ⅱ評分[(89.06±9.63)分]較單側組[(83.33±11.46)分]顯著增高,組間差異具有統計學意義(P＜0.05).結論 雙側TKA術後患者經早期繫統康複治療能穫得與單側TKA患者同樣良好的治療效果,併且其遠期膝關節活動功能恢複情況明顯優于單側TKA患者.
목적 관찰쌍측전슬관절치환술(TKA)여단측TKA술후조기전업강복치료적료효.방법 채용대비연구법장68례TKA환자분위단측조(36례)급쌍측조(32례).소유환자TKA술후균접수상동강복치료,술후평균주원강복시간위(15.0±3.7)d.우출원시채용동통VAS평분、슬관절활동도(ROM)급슬관절손상화골성관절염평정량표( KOOS)대2조환자슬관절공능진행평정,술후(10.52 ±4.41)개월수방시채용KOOS평분급미국슬관절협회량표(KSS)대2조환자원기슬관절회복정황진행평정.결과 출원시,쌍측조화단측조동통VAS평분분별위(16.89±5.17)분화(17.80±10.95)분,신슬불족분별위(1.88±2.61)°화(2.57±2.61)°,치환슬주동ROM분별위(102.89±14.35)°화(106.26±13.03)°,KOOS평분분별위(67.63 ±11.82)분화(67.52 ±12.07)분,2조간차이균무통계학의의(P＞0.05).수방시발현쌍측조급단측조KOOS평분분별위(96.11±2.31)분화(95.41±3.12)분,균교출원시명현제고(P＜0.05);차시2조환자KOOS화KSS-I평분조간차이균무통계학의의(P＞0.05),쌍측조KSS-Ⅱ평분[(89.06±9.63)분]교단측조[(83.33±11.46)분]현저증고,조간차이구유통계학의의(P＜0.05).결론 쌍측TKA술후환자경조기계통강복치료능획득여단측TKA환자동양량호적치료효과,병차기원기슬관절활동공능회복정황명현우우단측TKA환자.
Objective To observe and compare the functional outcomes of early rehabilitation of persons who received primary bilateral or unilateral total knee arthroplasty (TKA).Methods Sixty-eight subjects were divided into a unilateral TKA group (36 cases) and a bilateral TKA group (32cases).All received the same professional rehabilitation program during an average postoperative hospital stay of (15.00 ± 3.71 ) days.At discharge,a visual analogue scale (VAS) was used to rate pain.Active range of motion (AROM) of the involved knee,knee injury and an osteoarthritis outcome score (KOOS) were also assessed.The KOOS and knee society score (KSS) were evaluated at follow-up about 11 months later.Results There was no significant difference between the two groups in any assessment at discharge,nor in the KOOS and KSS-Ⅰ assessments at follow-up.The KOOS of both groups at follow-up had improved significantly compared with that at discharge.The KSS-Ⅱ results in the bilateral group were slightly better than those in the unilateral group at follow-up,and that difference was significant.Conclusions Bilateral TKA patients and unilateral TKA patients had the same clinical outcomes after early postoperative rehabilitation,but the functional outcomes of bilateral TKA patients were better than those of unilateral TKA patients a year later.
