[1 4 3 ]张洪美,孙钢,赵铁军,等人工全膝关节置换术治疗伸直 - 中国康复.doc

超声联合PNF对骨折后伸直型膝关节僵硬的疗效观察 杜宇鹏1 徐守宇1 2 （浙江中医药大学附属第三医院康复科 浙江杭州 310000） 摘要：目的：探讨超声联合PNF综合康复疗法对骨折后伸直型膝关节僵硬的疗效。方法：将符合纳入标准的53例膝关节僵硬患者随机分为传统组和康复组，在常规药物及肌力训练基础上分别给予传统关节松动术和PNF联合超声治疗。治疗两个月后观察关节活动度，视觉疼痛模拟评分和膝关节功能改善积分评估。结果：治疗后在关节活动度和膝关节功能改善积分方面，康复组优于传统组（P0.05），视觉疼痛模拟评分两组无明显差别（P0.05）。两组治疗前后组内比较，治疗后优于治疗前（P0.05）结论：超声联合PNF模式功能训练的综合康复疗法对膝关节僵硬功能的改善优于传统关节松动术 关键词：膝关节 僵硬 PNF 超声 Effection of ultrasonic combined PNF technology on knee joint stiffness. Abstract Objective To investigate the effection of comprehensive rehabilitation therapy which is ultrasonic combined PNF technology on knee joint stiffness. Methods 53 patients with knee joint stiffness included in the standard were divided into two groups which were traditional treatment group and rehabilitation treatment group, and the two groups were respectively given traditional joint mobilization and PNF combined ultrasonic treatment. After two months treatment, the knee motion was observed, visual analog pain score and the improvement of knee function score were assessed. Results The rehabilitation treatment is better than the traditional treatment on the knee motion and the improvement of knee function score after treatments（P0.05）,otherwise there is no significant different on the visual analog pain score between the two groups. The two groups before and after the treatment, compared with before treatment (P0.05). Conclusion The effection of PNF combined ultrasonic technology is better than traditional joint mobilization on knee joint stiffness. Keywords: The knee joint stiff PNF Ultrasonic Technology 膝关节僵硬是临床常见和多发病，多由损伤后长期制动引起[1]，严重影响患者的日常生活质量[2]。目前膝关节僵硬的治疗方法主要有关节松动术；理疗及手术松解等。但关节松动过程中疼痛较重，理疗疗效不显著，手术切开松解往往又会并发新的粘连[3-4]。使膝关节僵硬成为临床治疗的棘手问题。本研究主要探索利用PNF结合超声治疗的综合康复疗法对膝关节僵硬的疗效观察。 材料与方法 1.1病例来源 门诊收集符合纳入标准的膝关节创伤后或术后2个月内关节僵硬患者，剔除脱落病例，共53例，其中男30例，女23例（见表4.1），知情同意后在常规活血化瘀药物及肌力训练基础上上随机分为传统组（关节松动术），和康复组（超声+PNF组）。 1.2.纳入及排除标准 1.2.1.纳入标准： （1）.膝关节创伤后或术后2个月内； （2）.年龄20-70岁； （3）.经评定后存在关节活动受限，疼痛等； （4）.有自主行为及执行能力； （5）.经患者本人或家属同意。 1.2.2