摘要
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。
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 function 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 between 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 after 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 grouping 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 comprehensive 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.
出处
《中医正骨》
2014年第4期26-28,32,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
浙江省中医药科学研究基金项目(2010ZB140)
浙江省瑞安科技基金资助项目(201102056)
关键词
肘关节
骨折
手术后并发症
肘关节僵硬
中医康复
综合疗法
Elbow joint
Fractures
bone
Postoperative complications
Elbow joint rigidity
Rehabilitation（TCM）
Combined modality therapy
