术后系统康复治疗在促进关节镜下巨大肩袖损伤修补术后患者康复中的作用

关键词：术后系统康复治疗  巨大肩袖损伤修补术  术后康复  应用效果

Keywords:arthroscopy  massive rotator cuff  rehabilitation

摘要：

      摘要 目的：研究术后系统康复治疗在促进巨大肩袖损伤修补术后康复中的作用。 方法：以我院于2018年5月至2022年5月期间的患者作为样本，进行回顾性分析。患者均为关节镜下修补术治疗的巨大肩袖损伤患者，90例，选择术后能够每周坚持到院进行系统康复治疗的患者作为观察组（47例），应用北京积水潭医院康复科的康复方案；选择在术后仅来院接受常规康复指导的患者作为对照组（43例），分析一般资料后对患者手术治疗结束6个月后心理状态评分、Constant Murley肩关节评分、满意度进行对比，在此基础上，针对两组患者术后7周、3个月、6个月的肩关节主动前屈、主动外展以及主动体侧外旋关节活动度进行分析。 结果：各组患者在接受治疗后6个月进行随访，患者的心理状态评分、Constant Murley肩关节评分、满意度情况差异显著（P＜0.05），在术前不存在显著性差异的情况下，患者治疗后7周、3个月、6个月的肩关节主动前屈、主动外展以及主动体侧外旋关节活动度对比结果差异同样显著（P＜0.05），具有显著性意义。 结论：在面对巨大肩袖损伤患者的过程中，将关节镜下修补术治疗作为患者临床治疗方案后，在患者手术结束后引导患者开展系统康复治疗，有助于恢复患者肩关节功能，同时也可以改善患者的心理状态，提高治疗满意度。

Abstract:

      Abstract Objective： To explore the effectiveness of systematic rehabilitation training in promoting the recovery of patients with massive rotator cuff injury after arthroscopic repair. Method： A total of 90 cases with massive rotator cuff injury undergoing arthroscopic rotator cuff repair were retrospectively included from May 2018 to May 2022. Patients who could adhere to weekly postoperative systematic rehabilitation therapy were selected as the treatment group (n=47), utilizing the rehabilitation program from Beijing Jishuitan Hopsital. Those who only received routine rehabilitation guidance postoperatively were selected as the control group (n=43). General data were analyzed and patients were compared for psychological state scores, Constant-Murley shoulder scale and satisfaction levels 6 months after surgery. The range of motion（ROM）of active forward flexion， abduction and external rotation of shoulder were tested at 7 weeks， 3 months and 6 months after operation in both group. Result： There was no significant difference between two groups in Constant Murley scores before operation（P>0.05）. There were significant differences 6 months after operation（P<0.05）， the treatment group had higher scores than the control group in Constant Murley scores（P<0.05）. At 7 weeks， 3 months and 6 months after operation， ROM of shoulder in the treatment group were better than that in the control group（P<0.05）. Conclusion： Systematic and individual rehabilitation training for patients after arthroscopic repair of massive rotator cuff can effectively restore the function of shoulder joint， improve the psychological states and increases treatment satisfaction.