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目的探讨和评价早期镇痛联合阶梯康复训练对人工膝关节置换术后患者关节功能的影响。方法 88例进行人工膝关节置换术的患者,根据住院顺序分为甲组(46例)和乙组(42例)。甲组患者进行早期镇痛联合阶梯康复训练,乙组患者进行镇痛和康复训练(未作固定安排)。对比两组患者不同时间内膝关节屈伸范围以及疼痛和僵硬情况。结果甲组患者术后1 d、1周、3个月膝关节屈伸范围分别为(64.35±5.32)°、(91.35±9.38)°、(111.35±10.28)°,乙组患者术后1 d、1周、3个月膝关节屈伸范围分别为(44.87±5.18)°、(78.25±7.78)°、(91.28±6.28)°,两组比较差异均有统计学意义(P<0.05)。术后1周,甲组患者疼痛发生率为2.17%,低于乙组的19.05%,差异有统计学意义(P<0.05)。术后3个月,甲组关节僵硬发生率为4.35%,低于乙组的21.43%,差异有统计学意义(P<0.05)。结论对人工膝关节置换术患者进行早期镇痛联合阶梯康复训练,明显改善了患者膝关节屈伸范围,减轻了患者疼痛感,并且减少了关节僵硬发生的风险,值得推广。
Objective To investigate and evaluate the effect of early analgesia combined with step rehabilitation training on the joint function of patients after artificial knee replacement. Methods 88 patients undergoing artificial knee arthroplasty were divided into group A (n = 46) and group B (n = 42) according to the sequence of hospitalization. Patients in group A were given early analgesia combined with step rehabilitation training. Patients in group B received analgesia and rehabilitation training (no fixed schedule). The knee joint flexion and extension range, pain and stiffness were compared between the two groups. Results The range of flexion and extension at 1 d, 1 week and 3 months after operation in group A was (64.35 ± 5.32) °, (91.35 ± 9.38) ° and (111.35 ± 10.28) °, respectively The ranges of flexion and extension in one week and three months were (44.87 ± 5.18) °, (78.25 ± 7.78) ° and (91.28 ± 6.28) °, respectively. There was significant difference between the two groups (P <0.05). One week after operation, the incidence of pain in group A was 2.17%, which was lower than that in group B (19.05%), the difference was statistically significant (P <0.05). At 3 months after operation, the incidence of joint stiffness in group A was 4.35%, which was lower than that in group B (21.43%), the difference was statistically significant (P <0.05). Conclusions Early pain relief combined with stair rehabilitation training for patients undergoing artificial knee arthroplasty significantly improves the range of knee flexion and extension, alleviates the pain sensation in patients, and reduces the risk of joint stiffness, which is worthy of popularization.