中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
4期
26-28,32
,共4页
林光锚%刘良乐%叶丽洁%戴鸣海%王伟良
林光錨%劉良樂%葉麗潔%戴鳴海%王偉良
림광묘%류량악%협려길%대명해%왕위량
肘关节%骨折%手术后并发症%肘关节僵硬%中医康复%综合疗法
肘關節%骨摺%手術後併髮癥%肘關節僵硬%中醫康複%綜閤療法
주관절%골절%수술후병발증%주관절강경%중의강복%종합요법
Elbow joint%Fractures,bone%Postoperative complications%Elbow joint rigidity%Rehabilitation(TCM)%Combined modality therapy
目的：探讨综合康复计划在肘部骨折术后康复中的应用效果。方法：将72例肘部骨折术后患者随机分为2组，观察组35例和对照组37例。观察组采用综合康复计划治疗，对照组采用传统康复锻炼法治疗。分别于术后2周、4周和12周，采用Mayo评分法评价2组患者的肘关节功能。同时，观察对比2组患者肘关节僵硬的发生率。结果：①肘关节功能。不同时间点间肘关节功能Mayo评分的差异有统计学意义（F＝143.693，P＝0.000）；2组患者肘关节功能Mayo评分的组间差异总体上有统计学意义（t＝19.924，P＝0.000），进一步比较显示术后2周、4周、12周观察组的肘关节功能Mayo评分均高于对照组[（48.52±7.78）分，（36.68±5.28）分，t＝24.025，P＝0.000；（71.92±6.57）分，（55.78±4.72）分，t＝25.234，P＝0.000；（88.65±9.47）分，（61.36±7.76）分，t＝28.338，P＝0.000]；时间因素与分组因素存在交互效应（ F＝21.863，P＝0.000）。②肘关节僵硬发生率。观察组1例患者术后出现肘关节僵硬而影响日常生活，需返院行关节镜下松解术；对照组15例患者术后出现肘关节僵硬而影响日常生活，需返院行黏连松解术。观察组术后肘关节僵硬的发生率低于对照组（χ2＝14.770，P＝0.000）。结论：在肘部骨折术后康复中采用综合康复计划，可以预防肘关节僵硬的发生，改善肘关节功能，康复效果确切，值得临床推广应用。
目的：探討綜閤康複計劃在肘部骨摺術後康複中的應用效果。方法：將72例肘部骨摺術後患者隨機分為2組，觀察組35例和對照組37例。觀察組採用綜閤康複計劃治療，對照組採用傳統康複鍛煉法治療。分彆于術後2週、4週和12週，採用Mayo評分法評價2組患者的肘關節功能。同時，觀察對比2組患者肘關節僵硬的髮生率。結果：①肘關節功能。不同時間點間肘關節功能Mayo評分的差異有統計學意義（F＝143.693，P＝0.000）；2組患者肘關節功能Mayo評分的組間差異總體上有統計學意義（t＝19.924，P＝0.000），進一步比較顯示術後2週、4週、12週觀察組的肘關節功能Mayo評分均高于對照組[（48.52±7.78）分，（36.68±5.28）分，t＝24.025，P＝0.000；（71.92±6.57）分，（55.78±4.72）分，t＝25.234，P＝0.000；（88.65±9.47）分，（61.36±7.76）分，t＝28.338，P＝0.000]；時間因素與分組因素存在交互效應（ F＝21.863，P＝0.000）。②肘關節僵硬髮生率。觀察組1例患者術後齣現肘關節僵硬而影響日常生活，需返院行關節鏡下鬆解術；對照組15例患者術後齣現肘關節僵硬而影響日常生活，需返院行黏連鬆解術。觀察組術後肘關節僵硬的髮生率低于對照組（χ2＝14.770，P＝0.000）。結論：在肘部骨摺術後康複中採用綜閤康複計劃，可以預防肘關節僵硬的髮生，改善肘關節功能，康複效果確切，值得臨床推廣應用。
목적：탐토종합강복계화재주부골절술후강복중적응용효과。방법：장72례주부골절술후환자수궤분위2조，관찰조35례화대조조37례。관찰조채용종합강복계화치료，대조조채용전통강복단련법치료。분별우술후2주、4주화12주，채용Mayo평분법평개2조환자적주관절공능。동시，관찰대비2조환자주관절강경적발생솔。결과：①주관절공능。불동시간점간주관절공능Mayo평분적차이유통계학의의（F＝143.693，P＝0.000）；2조환자주관절공능Mayo평분적조간차이총체상유통계학의의（t＝19.924，P＝0.000），진일보비교현시술후2주、4주、12주관찰조적주관절공능Mayo평분균고우대조조[（48.52±7.78）분，（36.68±5.28）분，t＝24.025，P＝0.000；（71.92±6.57）분，（55.78±4.72）분，t＝25.234，P＝0.000；（88.65±9.47）분，（61.36±7.76）분，t＝28.338，P＝0.000]；시간인소여분조인소존재교호효응（ F＝21.863，P＝0.000）。②주관절강경발생솔。관찰조1례환자술후출현주관절강경이영향일상생활，수반원행관절경하송해술；대조조15례환자술후출현주관절강경이영향일상생활，수반원행점련송해술。관찰조술후주관절강경적발생솔저우대조조（χ2＝14.770，P＝0.000）。결론：재주부골절술후강복중채용종합강복계화，가이예방주관절강경적발생，개선주관절공능，강복효과학절，치득림상추엄응용。
Objective:To observe the effect of comprehensive rehabilitation program on postoperative rehabilitation of elbow fractures. Methods:Seventy-two patients with elbow fractures were randomly divided into 2 groups after the surgery,35 cases in observation group were treated with comprehensive rehabilitation,while 37 cases in control group were treated with traditional rehabilitation exercise. The func-tion of elbow joint were evaluated by using Mayo Elbow Performance Score( MEPS)at 2,4 and 12 weeks after the surgery. Meanwhile,the incidence of elbow joint stiffness were observed and compared between the 2 groups. Results:There was statistical difference in MEPS be-tween different time points(F=143. 693,P=0. 000). There was statistical difference in the MEPS between the 2 groups(t=19. 924,P=0. 000),and further comparison indicated that the MEPS of observation group were higher than those of control group 2,4 and 12 weeks af-ter the surgery(48. 52+/-7. 78 vs 36. 68+/-5. 28 points,t=24. 025,P=0. 000;71. 92+/-6. 57 vs 55. 78+/-4. 72 points,t=25. 234, P=0. 000;88. 65+/-9. 47 vs 61. 36+/-7. 76 points,t=28. 338,P=0. 000). There was interaction effect between time factor and group-ing factor(F=21. 863,P=0. 000). Postoperative elbow joint stiffness were found in one patient(observation group)and 15 patients(control group),whose daily life were affected,and then the patients were treated with arthroscopic lysis. The incidence of postoperative elbow joint stiffness of observation group was lower than that of the control group(χ2 =14. 770,P=0. 000). Conclusion:The application of comprehen-sive rehabilitation program can prevent the elbow joint stiffness and improve the elbow joint function after the surgery for elbow fractures, and it is worth popularizing in clinic for its reliable rehabilitative effect.
