| 曲宝君,薛慧,苏昕.持续被动运动初始角度对单侧全膝关节置换术后早期康复的影响[J].安徽医药,2020,24(7):1402-1406. |
| 持续被动运动初始角度对单侧全膝关节置换术后早期康复的影响 |
| Effect of initial angle of continuous passive motion on early rehabilitation after unilateral total knee arthroplasty |
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| DOI：10.3969/j.issn.1009?6469.2020.07.034 |
| 中文关键词: 关节成形术，置换，膝/康复 运动疗法，持续被动性 /方法 活动范围，关节 运动活动 早日下床活动 静脉血栓形成 膝关节主动活动度 |
| 英文关键词: Arthroplasty,replacement,knee/rehabilitation Motion therapy,continuous passive/ methods Range of motion, articular Motor activity Early ambulation Venous thrombosis Active range of motion |
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| 中文摘要: |
| 目的探讨持续被动运动( Continuous Passive Motion，CPM)初始角度对单侧全膝关节置换术后早期康复的影响。方法 2017年 8月至 2019年 6月采用简单随机法抽取青岛市市立医院关节科膝关节置换病人 120例纳入研究，每组各 40例，其中 9例因不能依从治疗退出研究，根据研究方案将病人分为三组，三组病人术后 CPM初始角度分别设定为 20°(小角度组， 40例)最大屈曲角 -10°(耐受组， 40例)和最大屈曲角(最大耐受组， 31例)术后 24 h后开始 CPM康复锻炼，以 NRS法评估每例病人，疼痛情况，并进行统计分析，术后第 3、7d测量病人膝关节主动活动度(，Active Range of Motion，AROM)，对比三组病人膝关节功能恢复情况，评估三种方法的近期疗效，并对各组病人伸膝迟滞和下肢深静脉血栓等不良事件发生率的差异进行比较。结果最大耐受组依从率为 77.5%，其余两组均完全依从。术后 3d，小角度组、耐受组、最大耐受组 AROM分别为( 43.41± |
| 英文摘要: |
| Objective To explore the effect of initial flexion of continuous passive motion(CPM)on early rehabilitation after total knee arthroplasty.Methods From August 2017 to June 2019，120 patients with knee arthroplasty in Qingdao Municipal Hospital were randomly selected in this study，with 40 patients in each group.Nine patients incompatible with the treatment were excluded.All the patients were divided into three groups.The initial motion range of CPM for the three groups were set as 20°(the small flexion group)， 20°，the maximum flexion angle minus 10°(the medial group)and the maximum flexion angle(the maximum flexion group)，respectively.CPM exercise was started 24 hours after operation.The pain of each patient was assessed by NRS，and the AROM of knee was measured on the 3rd and 7th day after operation.We estimated knee function and analyzed the differenceof incidence of adverse events such as deep venous thrombosis among the three groups.Results The compliance rate of the maxi? mal flexion group was 77.5%，and the other two groups fully adhered to the treatment.The AROM of the three groups on the 3rd day after operation were(43.41±9.87)°，(51.46±9.80)° and(57.73±10.62)°，respectively，with significant difference among the three groups.On the 7th day，the AROM of the maximum flexion group(89.88±8.53)° and the medial flexion group(88.60±8.34)° was significantly higher than that of the small flexion group(71.11±10.03)°，but there was no significant difference be? tween maximum flexion group and median group.Also，there was no significant difference in knee extension delay and deep venousthrombosis among these groups.From the 2nd day to the 4th day after operation，the NRS score of maximum flexion group was higher than that of the median and small group，and the difference was statistically significant.From the 5th to 7th day after opera? tion，there was no significant difference in patients’scores among the three groups.Conclusion CPM can promote the rehabilita? tion of joint range of motion after total knee arthroplasty，but rehabilitation requires a certain degree of intensity.It is recommendedto set the initial angle as the maximum tolerance angle of -10°，so that CPM can not only be complied with by patients，but also ensure clinical efficacy. |
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