前交叉韧带重建术后康复一体化干预△

Integrated rehabilitation intervention after anterior cruciate ligament reconstruction

摘要:

[目的] 探讨快速康复理念“康复一体化”干预在前交叉韧带重建术后 （anterior cruciate ligament reconstruction, ACLR） 功能恢复中的应用效果。[方法] 85 例 ACLR 患者纳入本研究，采用随机数字表法分为两组，43 例予以快速康复理念下“康复一体化”干预 （干预组），42 例采用常规护理方法 （常规组），对比临床资料。[结果]与干预前相比，8 周后两组的 VAS 评分、Lysholm 评分、膝关节活动度及 SF-36 量表生活质量的 8 个维度评分均显著改善（P＜0.05）。干预前，两组间上述指标的差异均无统计学意义（P＞0.05），干预 8 周后，干预组的 VAS 评分 [(4.0±0.5) vs (5.0±0.5), P＜0.001]、Lysholm 评分 [(68.7±9.3) vs (57.9±6.4), P＜0.001]、膝关节活动度 [(59.2±8.4)° vs (51.9±6.9)°, P＜0.001] 及 SF-36 量表生活质量的 8 个维度评分均显著优于常规组 （P＜0.05），末次随访干预组的护理满意度显著高于常规组（P＜0.05）。[结论]前交叉韧带重建术患者应用快速康复理念的“康复一体化”干预能够促进术后快速康复。

Abstract:

[Objective] To investigate the clinical outcome of the integrated rehabilitation based on fast track surgery (FTS) after anterior cruciate ligament reconstruction (ACLR). [Methods] A total of 85 patients who were undergoing ACLR were included in this study and divided into two groups by random number table method. Of them, 43 patients received integrated rehabilitation under the concept of FTS (the intervention group), while other 42 patients were given conventional rehabilitation and nursing care (the routine group). The clinical data were compared between the two groups. [Results] The VAS and HSS scores, as well as knee range of motion and 8 dimensions of SF-36 score were significantly improved in both groups 8 weeks postoperatively compared with those before intervention (P＜0.05). There was no statistical significance in the above indexes between the two groups before intervention (P＞0.05), however, the intervention group proved significantly superior to the conventional group in terms of VAS score [(4.0±0.5) vs (5.0±0.5), P＜0.001], Lysholm score [(68.7±9.3) vs (57.9±6.4), P＜0.001], knee range of motion (ROM) [(59.2±8.4)° vs (51.9±6.9)°, P＜0.001] and SF-36 score for quality of life in 8 dimensions 8 weeks after intervention. The intervention group was also sigificantly better than the conventional group in term of satisfaction to nursing care at the last follow-up (P＜0.05). [Conclusion] The rehabilitation integration intervention based on fast track surgery does promote the rapid recovery after anterior cruciate ligament reconstruction.