CAJ | 학술논문

目的探讨行Ⅰ期双侧全膝关节置换术患者的康复方法及疗效.方法 2004年1月至2007年1月,共有120例患者入院接受Ⅰ期双侧全膝关节置换术,按入院时间顺序随机分成交替康复组和传统康复组,2组均于术前、术后行康复训练.交替康复组采用交替法,即每个康复动作左右侧肢体交替进行;传统康复组采用传统方法进行康复训练.即一侧肢体完成一项康复训练动作后,再行对侧肢体康复训练.分别在术前1 d以及术后1个月、3个月、6个月和1年记录2组的膝关节活动度、美国特种外科医院(HSS)膝关节评分和健康评定量表(SF-12)健康状态评分;记录术后2周目测类比评分法(VAS)疼痛评分和术后3个月下肢深静脉血栓(DVT)的发生率.结果 115例患者完成研究,交替康复组术后早期的VAS疼痛评分较低,膝关节术后1个月和3个月的膝关节功能评分较高,SF-12健康状态评分较高,与传统康复组比较,差异有统计学意义(P<0.01).结论与传统康复方法相比,交替康复法对减轻Ⅰ期双侧全膝关节置换术后的早期疼痛、提高膝关节术后早期功能、加快膝关节术后康复速度效果更佳.
목적 탐토행Ⅰ기쌍측전슬관절치환술환자적강복방법급료효.방법 2004년1월지2007년1월,공유120례환자입원접수Ⅰ기쌍측전슬관절치환술,안입원시간순서수궤분성교체강복조화전통강복조,2조균우술전、술후행강복훈련.교체강복조채용교체법,즉매개강복동작좌우측지체교체진행;전통강복조채용전통방법진행강복훈련.즉일측지체완성일항강복훈련동작후,재행대측지체강복훈련.분별재술전1 d이급술후1개월、3개월、6개월화1년기록2조적슬관절활동도、미국특충외과의원(HSS)슬관절평분화건강평정량표(SF-12)건강상태평분;기록술후2주목측류비평분법(VAS)동통평분화술후3개월하지심정맥혈전(DVT)적발생솔.결과 115례환자완성연구,교체강복조술후조기적VAS동통평분교저,슬관절술후1개월화3개월적슬관절공능평분교고,SF-12건강상태평분교고,여전통강복조비교,차이유통계학의의(P<0.01).결론 여전통강복방법상비,교체강복법대감경Ⅰ기쌍측전슬관절치환술후적조기동통、제고슬관절술후조기공능、가쾌슬관절술후강복속도효과경가.
Objective To study the outcomes of 2 rehabilitation protocols after simultaneous stage Ⅰ bilateral total knee replacement (TKR). Methods One hundred and twenty patients admitted for stage Ⅰ bilateral TKR were assigned randomly to receive alternative or traditional rehabilitation therapy. Rehabilitation training was administered in both alternative and traditional groups before and after operation. In alternative group, each rehabilitation action was designed to be done on one side and the other side alternatively. In traditional group, each training session was designed to be done on one side and then followed by the other side in succession. Visual analogue scale (VAS)scores were evaluated for 2 weeks after operation and deep vein thrombosis (DVT) complications were recorded for 3 months after operation. The range of motion ( ROM), American hospital special surgery (HSS) knee scores and SF-12 scores were recorded at 1 d before operation and the 1st, 3rd, 6th and 12th month after operation, Results One hundred and fifteen patients completed all training sessions and assessments. Compared with traditional group, alter-native group had significantly lower VAS scores in the early postoperation stage and significantly better knee function scores and SF-12 scores at the 1 st and 3rd month postoperation (P <0. 005). Conclusion The alternative protocol can speed up rehabilitation and lead to decrease VAS scores in the early postoperation stage, and improve knee func-tion and physical and mental health after TKR.