金伟

[摘要] 目的 探討激进康复训练联合神经肌肉电刺激对关节镜下前交叉韧带重建术后关节功能恢复的影响。 方法 回顾性分析南京大学医学院附属鼓楼医院2014年9月～2016年3月收治的72例行关节镜下前交叉韧带重建术患者资料，患者均采用激进康复，根据是否联合神经肌肉电刺激将患者分为对照组和联合组，各36例。对照组仅采用激进康复训练，联合组在对照组基础上联合神经肌肉电刺激，均进行为期6周的治疗，随访6周。比较两组治疗前和治疗后2、4、6周关节活动度，关节功能和治疗及随访期不良反应情况。 结果 治疗前，两组关节活动度比较，差异无统计学意义（P > 0.05）；治疗后2、4、6周，两组关节活动度均较治疗前提高，且联合组关节活动度高于同期对照组（P < 0.05）。治疗前，两组关节功能评分比较，差异无统计学意义（P > 0.05）；治疗后2、4、6周，两组关节功能评分均较治疗前提高，且联合组关节功能评分高于同期对照组（P < 0.05）。两组在治疗及随访期均未出现任何不良反应情况，安全性好。 结论 激进康复联合神经肌肉刺激可以帮助更快获得满意的功能，且无不良反应，值得临床推广。

[关键词] 激进康复训练；神经肌肉电刺激；关节活动度；关节功能

[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210（2016）12（c）-0121-04

[Abstract] Objective To explore the influence of aggressive rehabilitation training combined with nerve muscle electrical stimulation on joint function recovery after anterior cruciate ligament reconstruction under arthroscopy. Methods Clinical data of 72 cases of patients treated with anterior cruciate ligament reconstruction under arthroscopy in Drum Tower Hospital Affiliated to Nanjing University School of Medicine from September 2014 to March 2016 were analyzed retrospectively. All patients were given aggressive rehabilitation training， according to whether combined with nerve muscle electrical stimulation or not， patients were divided into control group and combination group， each group had 36 cases. The patients in control group were given aggressive rehabilitation training， and patients in combination group were given nerve muscle electrical stimulation on the basis of control group. All patients were treated for 6 weeks and followed up for 6 weeks. The degree of joint motion and joint function before treatment， and after treatment of 2， 4 and 6 weeks， and adverse reaction during the treatment and follow-up period were compared between two groups. Results Before treatment， there was no significant difference in degree of joint motion between two groups （P > 0.05）. After treatment 2， 4 and 6 weeks， degrees of joint motion in two groups were higher than before treatment， which of combination group were higher than those of control group at the same time （P < 0.05）. Before treatment， there was no significant difference in score of joint function between two groups （P > 0.05）. After treatment 2， 4 and 6 weeks， scores of joint function in two groups were higher than before treatment， which of combination group were higher than those of control group at the same time （P < 0.05）. There was no adverse reaction in two groups during the treatment and follow-up period， the treatment had good safety. Conclusion Aggressive rehabilitation training combined with nerve muscle electrical stimulation can faster to get satisfactory function， with no adverse reactions. It is worthy for promoting in clinic.

[Key words] Aggressive rehabilitation training； Nerve muscle electrical stimulation； Degree of joint motion； Joint function

前交叉韧带损伤是临床上较常见的一种疾病，常见于剧烈运动或各种交通事故，损伤或断裂后引起关节前后方向及旋转不稳[1-2]。若未采取及时治疗，则直接影响广大前交叉韧带损伤患者的关节功能、运动能力和日常生活，提示临床上采取及时的手术治疗及术后康复训练尤为重要。当前，临床上存在多种关节镜下前交叉韧带重建术后康复功能训练方案，但何时采用何种强度、频率的训练尚未明晰，临床医生应充分考虑患者的性别、年龄、损伤程度、骨质情况等因素，综合分析患者病情[3-4]，为患者制订高效且安全的术后康复治疗方案。本……