Clinical effect of massage combined with early rehabilitation training after arthroscopic meniscus arthroplasty of the knee
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摘要:
目的 探讨膝关节镜下半月板成形术后应用推拿手法联合早期康复训练的临床效果。 方法 选取2019年4月—2020年5月在浙江大学丽水医院行膝关节镜下关节半月板成形术的患者96例，根据随机数字表法随机分为观察组和对照组，各48例。对照组患者术后行早期康复训练治疗，观察组患者术后行推拿手法联合早期康复训练治疗。比较2组患者的临床治疗效果。 结果 治疗前，2组患者VAS评分比较差异无统计学意义(P>0.05)，2组患者术后1 d、术后3 d、术后1周VAS评分较治疗前均明显降低(均P < 0.05)，观察组术后各时间点VAS评分明显低于对照组患者(均P < 0.01)。治疗前，2组患者Lysholm评分比较差异无统计学意义(P>0.05)，2组患者术后1 d、术后3 d和术后1周与治疗前相比较，Lysholm评分均明显升高(均P < 0.05)，观察组患者术后3 d和术后1周的Lysholm评分明显高于对照组患者(均P < 0.05)。在膝关节功能疗效方面，观察组患者膝关节功能优良率为89.68%，对照组为64.58%，观察组膝关节功能优良率明显高于对照组患者(χ2=8.491，P=0.004)。 结论 膝关节镜下半月板成形术后对患者采用推拿手法联合早期康复训练能有效降低患者疼痛，促进膝关节功能恢复，提高膝关节功能的优良率，具有较高的临床价值。 Abstract:Objective To investigate the clinical effect of massage combined with early rehabilitation training after arthroscopic meniscus arthroplasty of the knee. Methods A total of 96 patients who underwent meniscus arthroplasty in our hospital from April 2019 to May 2020 were selected and randomly divided into the observation and control groups (48 cases each group) according to the random number table method. The patients in the control group received early rehabilitation training after operation, whereas those in the observation group received manipulation massage combined with early rehabilitation training after operation. The clinical therapeutic effects of the two groups were compared. Results Before treatment, the VAS scores of patients in the two groups were not statistically significant (P>0.05). The VAS scores of patients in the two groups at 1 day, 3 days and 1 week after surgery were significantly lower than those before treatment (all P < 0.05). The VAS scores of patients in the observation group at each time point after surgery were significantly lower than those in the control group (all P < 0.01). Before treatment, no significant difference was observed in the Lysholm scores between the two groups (P>0.05). The Lysholm scores were significantly increased in the two groups 1 day, 3 days and 1 week after surgery compared with those before treatment (all P < 0.05). The Lysholm scores in the observation group 3 days and 1 week after surgery were significantly higher than those in the control group (all P < 0.05). In terms of the efficacy of knee joint function, the excellent and good rate of knee joint function in the observation group (89.68%) was significantly higher than that in the control group (64.58%, χ2=8.491, P=0.004). Conclusion After arthroscopic meniscus arthroplasty of the knee, massage combined with early rehabilitation training can effectively reduce the pain of patients, promote the recovery of knee joint function and improve the excellent and good rate of knee joint function, which has a high clinical value. -
Key words:
- Knee arthroscope /
- Meniscus plasty /
- Massage /
- Early rehabilitation training /
- Clinical effect
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表 1 2组膝关节镜下半月板成形术患者治疗前后VAS评分比较(x±s, 分)
组别 例数 治疗前 术后1 d 术后3 d 术后1周 F值 P值 观察组 48 4.83±1.13 3.03±1.13a 2.72±1.02ab 1.72±0.36abc 8.592 < 0.001 对照组 48 4.79±1.15 4.19±1.05a 3.86±1.12ab 3.09±0.43abc 6.396 < 0.001 t值 0.172 5.210 5.214 16.925 P值 0.864 < 0.001 < 0.001 < 0.001 注：与治疗前比较，aP < 0.05;与同组术后1 d比较，bP < 0.05;与同组术后3 d比较，cP < 0.05。 
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表 2 2组膝关节镜下半月板成形术患者治疗前后膝关节Lysholm评分比较(x±s, 分)
组别 例数 治疗前 术后1 d 术后3 d 术后1周 F值 P值 观察组 48 66.62±5.73 71.65±5.81a 76.82±7.35ab 85.26±6.87abc 12.985 < 0.001 对照组 48 65.56±5.62 69.45±5.72a 72.93±7.73ab 76.37±6.92abc 11.679 < 0.001 t值 0.915 1.869 2.527 60.61 P值 0.363 0.065 0.013 < 0.001 注：与治疗前比较，aP < 0.05;与同组术后1 d比较，bP < 0.05;与同组术后3 d比较，cP < 0.05。
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表 3 2组膝关节镜下半月板成形术患者膝关节功能治疗总有效率比较
组别 例数 优[例(%)] 良[例(%)] 可[例(%)] 差[例(%)] 优良率(%) 观察组 48 21(43.75) 22(45.83) 3(6.25) 2(4.17) 89.68 对照组 48 13(27.08) 18(37.50) 8(16.67) 9(18.75) 64.58 注：2组总有效率比较，χ2=8.491，P=0.004。
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