运动疗法联合CPM促进膝关节周围骨折术后功能康复的效果观察

目的观察运动疗法联合持续被动活动(continuous passive motion,CPM)对膝关节周围骨折术后功能康复的临床效果。方法选取2016年11月—2018年11月收治的行手术治疗的膝关节周围骨折101例作为研究对象,按照术后治疗方法的不同,分为对照组(n=52)与观察组(n=49)。两组均予骨关节CPM治疗,在此基础上,观察组联合运动疗法。评估两组术前与术后3个月膝关节功能改善情况、膝关节临床症状、膝关节活动情况,比较两组术前与术后10 d炎性因子相关指标变化,记录两组术后3个月的临床疗效。结果与对照组比较,观察组术后3个月特种外科医院评分、膝关节活动度评分升高,疼痛、肿胀、淤斑与乏力评分、膝关节伸直缺失程度与膝关节稳定度评分均降低,差异有统计学意义(P<0.01);与本组术前比较,两组术后3个月特种外科医院评分、膝关节活动度评分升高,疼痛、肿胀、淤斑与乏力评分、膝关节伸直缺失程度与膝关节稳定度评分下降,差异有统计学意义(P<0.01)。与对照组比较,观察组术后10 d C-反应蛋白、红细胞沉降率、肿瘤坏死因子-α水平下降,差异有统计学意义(P<0.01);与本组术前比较,两组术后10 d C-反应蛋白水平降低,红细胞沉降率、肿瘤坏死因子-α水平升高,差异有统计学意义(P<0.01)。对照组、观察组治疗总有效率分别为75.00%、91.84%,比较差异有统计学意义(P=0.043)。结论运动疗法配合CPM治疗可以促进膝关节周围骨折术后患者的功能康复,改善临床症状,提高治疗效果。

Effect of Exercise Therapy Combined with CPM in Promoting Functional Rehabilitation after Operation of Periarticular Fracture of Knee Joint

Objective To observe the effect of exercise therapy combined with continuous passive motion(CPM)in promoting functional recovery after operation of periarticular fractures of the knee joint.Methods From November 2016 to November 2018,101 patients with periarticular fracture of the knee joint who were enrolled in our hospital were selected.According to different treatment methods postoperatively,they were divided into control group(n=52)and observation group(n=49).Both groups were treated with CPM,and on this basis,the observation group was supplemented with exercise therapy.The improvement of knee joint function,clinical symptoms and activities of knee joint between the two groups were evaluated before and at 3 months after operation,and the changes of inflammatory factor related indicators between the two groups before and at 10 days after operation were compared.In addition,the clinical effects of the two groups at 3 months after operation were recorded.Results Compared with the control group,the scores of hospital for special surgery and knee joint activity were increased,while the scores of pain,swelling,ecchymosis and asthenia,and knee joint extension loss and the scores of knee joint stability were decreased in the observation group at 3 months after operation(P<0.01).Compared with the preoperative score of this group,the scores of hospital for special surgery and knee joint activity were increased,whereas the scores of pain,swelling,ecchymosis and asthenia,knee joint extension loss and the score of knee joint stability were decreased in the two groups at 3 months after operation(P<0.01).Compared with the control group,the levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and the level of tumor necrosis factor-αwere decreased significantly in the observation group at 10 days after operation(P<0.01).Compared with the group before operation,the levels of CRP was decreased,while ER and the level of tumor necrosis factor-αwere increased significantly in the two groups at 10 days after operation(P<0.01).The total effective rates of the control group and the observation group were 75.00%and 91.84%,respectively,with a statistically significant difference(P=0.043).Conclusion Exercise therapy combined with CPM can promote functional rehabilitation of patients after operation of periarticular fractures of the knee joint,and improve clinical symptoms and the therapeutic effect.