经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能的影响

目的探讨经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能障碍患者胃肠功能恢复的影响。方法:选择2020年1月—2022年12月我院收治的94例膝单髁关节置换术后胃肠功能障碍患者,采用随机数字表法将患者均分为两组,对照组(47例)采用经皮穴位电刺激治疗,观察组(47例)采用经皮穴位电刺激联合厚朴三物汤治疗。观察两组疗效、中医症候积分、胃肠道恢复、腹痛和腹胀程度、血清胃肠激素水平和不良反应。结果:两组均无脱落病例。观察组治疗有效率高于对照组(95.74% vs 74.47%,P＜0.05),观察组第1次肛门排气时间[(23.35±4.16) h vs (30.15±5.26] h)],第1次排便时间[(51.32±7.23) h vs (62.35±10.77) h],第1次肠鸣音恢复时间[(14.21±2.41)h vs (17.24±3.49) h],开始进食时间[(74.35±10.49)h vs (80.26±13.65) h]均短于对照组(P＜0.05)。两组治疗后腹部胀满、大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平均较治疗前降低(P＜0.05),且观察组治疗后腹部胀满,大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平低于对照组(P＜0.05),两组治疗后血清胃动素、胃泌素均较治疗前降低(P＜0.05),且观察组治疗后血清胃动素、胃泌素低于对照组(P＜0.05)。结论:经皮穴位电刺激联合厚朴三物汤可增强胃肠动力,促使胃肠功能恢复,缓解腹痛腹胀症状,在膝单髁关节置换术后胃肠功能障碍治疗中优于单独经皮穴位电刺激治疗。     

Effects of incorporating elliptical trainer exercise during rehabilitation on physical function and self-reported outcomes after total hip arthroplasty: a randomized controlled trial

[Purpose] To investigate the effects of incorporating elliptical trainer exercise in early rehabilitation after total hip arthroplasty on physical function and self-reported outcomes. [Participants and Methods] Participants with independent gait prior to total hip arthroplasty underwent conventional postoperative physiotherapy and were divided into two groups. The intervention group additionally underwent elliptical trainer exercise, while the control group underwent a walking program. The main outcomes were low back and hip region pain, lower limb muscle strength, single-leg stance time, Timed Up & Go Test results, 10 m walking test results, hip disability and osteoarthritis outcome score, and modified fall efficacy scale score. These outcomes were evaluated preoperatively, at discharge, and at 1 and 3 months postoperatively. [Results] Fifty participants (including 40 females; age, 68.3 ± 10.8 years) participated in this study. Physical function evaluations showed a significant improvement in hip region pain during walking at discharge. Knee extensor strength, single-leg stance time, stride length, and walking speed were significantly greater in the intervention group at discharge and at 1 and 3 months postoperatively. The modified fall efficacy scale score significantly improved in the intervention group 1 month postoperatively. [Conclusion] Elliptical trainer exercise and conventional physiotherapy in the early postoperative period contribute to improved physical function and walking ability and improvement in the fear of falling.     

膝关节镜结合中药熏洗治疗膝骨关节炎的临床效果

目的:探讨膝关节镜结合中药熏洗方案治疗膝骨关节炎(KOA)患者的临床效果.方法:收集2014年1月—2016年12月玉田县中医医院诊治的66例KOA患者,按照治疗方案不同分为两组,对照组(32例)行单纯中药熏洗治疗,观察组(34例)行关节镜清理术联合中药熏洗治疗,回顾观察并分析患者疼痛程度、关节症状、炎性因子水平、生活...     

膝关节外伤的磁共振成像(MRI)检查及临床诊断

目的 探讨膝关节外伤的磁共振成像（MRI）表现,评价膝关节外伤的MRI检查及其诊断价值。方法 采用回顾性分析对经手术、关节镜检查或临床证实的75例膝关节外伤,把正常与不正常的膝关节MRI进行对比观察。结果 39例半月板损伤;53例损伤的韧带;单纯性滑膜囊或关节囊积液4例;骨挫伤5例;正常2例。其中膝关节损伤合并关节积液的有18例,骨挫伤合并韧带损伤2例,合并半月板损伤3例。结论 MRI能够清晰显示膝关节解剖结构,能准确诊断膝关节骨折、骨挫伤、韧带损伤、半月板损伤及关节积液,并进行分级,是膝关节外伤较理想的一种非创伤性检查方法,有很好的准确性和细微性,可为临床治疗方式提供依据。     

人工髋关节置换术早期并发症临床分析

目的探讨人工髋关节置换术早期并发症的防治方法。方法分析21例人工髋关节置换术患者发生早期并发症的原因并提出防治措施。结果21例中假体柄周围骨折7例,术后早期脱位5例,下肢深静脉栓塞8例,下肢不等长1例。经治疗后效果满意。结论术中正确的手术操作、术后早期进行功能康复能有效地防止或减少早期并发症的发生。     

针刀治疗膝关节骨性关节炎临床研究

目的：针刀治疗膝关节骨性关节炎的效果。方法：按照通行诊断标准和排除标准确定受试者纳入范围,按照单盲随机原则对受试者（98例）分两组治疗,一组为观察组（50例）接受针刀治疗,另一组为对照组（48例）接受封闭针治疗,连续治疗3周（每周1次）,比较疗效。采用专业指数量表给两组病人在疼痛、僵硬、关节功能三方面进行量化评估。结果：观察组和对照组有效率分别达到了94.00％和72.92％,且存在统计检验上的显著差异;治疗后各指标评估分值均大幅降低,观察组低于对照组,同样存在统计检验上的显著差异。结论：针刀技术治疗膝关节骨性关节炎效果显著。     

人工全膝关节表面置换治疗骨关节疾病52例

目的探讨人工全膝关节表面置换(TKA)治疗骨关节病的疗效。方法对52例56个膝关节行TKA。结果52例均获随访,时间10~62个月,平均48.4个月。患者术后在疼痛、功能方面改善明显;膝关节评分应用HSS评分系统,由术前平均46.2分提高到86.3分。术后52个膝关节平均活动度为108,°53个膝关节术后膝关节力线正常,3膝残留6°~8°内翻。手术优良率90.4%。结论TKA对治疗严重膝关节炎效果满意,术中精确的截骨及正确的软组织松解以获得软组织平衡和注重术中髌骨轨迹的纠正是手术成功的关键。     

超声引导下髋关节囊周围神经阻滞联合椎管内麻醉在老年患者全髋关节置换术中的应用

目的 评价超声引导下髋关节囊周围神经(PENG)阻滞应用于老年患者全髋关节置换术中的有效性及安全性.方法 选择2019年8月至2020年1月择期因股骨颈骨折于椎管内麻醉下行全髋关节置换术的老年患者40例,男23例,女17例,年龄65～80岁,BMI 16～28 kg/m2,ASAⅡ或Ⅲ级.采用随机数字表法将患者分为两组...     

Sonography detection threshold for knee effusion

The aim of this study was to determine the threshold for detecting knee effusion by ultrasound (US). Five knee specimens from embalmed cadavers were studied. Intra-articular injection of saline, blood and synovial fluid was performed under ultrasound control and methylene blue dye instillation. The smallest amount of fluid detectable by US in the knee was 7.4 ml for synovial fluid, 10.1 and 10.4 ml for saline solution and 9.7 for blood. The threshold for detecting knee joint effusion by US in cadaver specimens was 10 ml for saline and blood and 7 ml for synovial fluid.Abbreviations US Ultrasound     

人工全膝关节置换术患者康复教育与训练

目的 探讨人工全膝关节置换术患者的有效康复训练方法.方法 选择接受TKA的患者28例34个膝关节,实施系统化、规范化康复训练方案,包括关节活动训练、股四头肌和腘绳肌肌力的训练以及下肢步行能力的训练.结果 本组病例获随访5个月～3年,采用美国膝关节外科学会膝关节评分标准,优22例,良8例,优良率100%.结论 TKA患者围手术期的系统化、规范化康复训练是提高人工全膝关节置换术效果的有效措施.