【摘要】 目的:观察红外热成像技术在指导肘关节骨化性肌炎松解术后康复锻炼中的应用价值。方法:将符合要求的84例肘关节骨化性肌炎患者随机分为2组,每组42例,分别在红外热成像技术指导下进行常规康复锻炼(观察组)和单纯常规康复锻炼(对照组)。两组均于术后24 h开始进行常规康复锻炼,每天6~9次,每次30 min,共锻炼14 d;于术后3 d开始,观察组用医用红外热成像仪测量患者锻炼后双侧肘关节的温度差,并根据其大小调整锻炼强度。分别于康复锻炼前和康复锻炼结束后24周,比较2组患者的肘关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、肘关节活动度和骨化性肌炎复发率。结果:(1)肘关节疼痛VAS评分。康复锻炼前2组患者肘关节疼痛VAS评分比较,差异无统计学意义(t=-0. 104,P=0. 749);康复锻炼结束后24周,2组患者肘关节疼痛VAS评分均低于康复锻炼前[(0. 75±0. 09)分,(2. 13±0. 19)分,t=-9. 840,P=0. 000;(1. 36±0. 14)分,(2. 06±0. 21)分,t=-3. 640,P=0. 001],观察组肘关节疼痛VAS评分低于对照组(t=-4. 224,P=0. 000)。(2)肘关节活动度。康复锻炼前2组患者肘关节活动度比较,差异无统计学意义(t=-1. 904,P=0. 352);康复锻炼结束后24周,2组患者肘关节活动度均大于康复锻炼前(99. 70°±2. 90°,11. 50°±3. 20°,t=-10. 691,P=0. 000; 70. 50°±3. 20°,12. 10°±3. 10°,t=-8. 738,P=0. 000),观察组肘关节活动度大于对照组(t=10. 036,P=0. 000)。(3)骨化性肌炎复发率。康复锻炼结束后24周,观察组骨化性肌炎复发1例,对照组骨化性肌炎复发15例;观察组骨化性肌炎复发率低于对照组(χ~2=15. 132,P=0. 000)。结论:采用红外热成像技术指导肘关节骨化性肌炎松解术后的康复锻炼,可更好地缓解肘关节疼痛,改善肘关节活动度,降低骨化性肌炎的复发率,值得临床推广应用。更多还原

【Abstract】 Objective: To explore the applied value of infrared thermography for guiding rehabilitation exercises after release surgery for treatment of elbow myositis ossificans. Methods: Eighty-four patients with elbow myositis ossificans were randomly divided into 2 groups,42 cases in each group. The patients were treated with conventional rehabilitation exercises under the guidance of infrared thermography( observation group) and monotherapy of conventional rehabilitation exercises( control group) respectively. The conventional rehabilitation exercises were performed since the 24 th hour after the surgery,6-9 times a day and 30 minutes at a time for consecutive 14 days. The temperature difference between bilateral elbow joints of patients in observation group were measured by using medical infrared thermal imager after rehabilitation exercises since the 3 rd day after the surgery,and the exercise intensity was adjusted according to the temperature difference.The elbow pain visual analogue scale( VAS) scores,range of motion( ROM) of elbow and recurrence rate of myositis ossificans were compared between the 2 groups before rehabilitation exercises and at 24 weeks after the end of rehabilitation exercises respectively. Results:There was no statistical difference in elbow pain VAS scores between the 2 groups before rehabilitation exercises( t =-0. 104,P = 0. 749).The elbow pain VAS scores were lower in both of the 2 group at 24 weeks after the end of rehabilitation exercises compared to pre-rehabilitation exercises( 0. 75 +/-0. 09 vs 2. 13 +/-0. 19 points,t =-9. 840,P = 0. 000; 1. 36 +/-0. 14 vs 2. 06 +/-0. 21 points,t =-3. 640,P = 0. 001),and the elbow pain VAS scores were lower in observation group compared to control group( t =-4. 224,P = 0. 000). There was no statistical difference in ROM of elbow between the 2 groups before rehabilitation exercises( t =-1. 904,P = 0. 352). The ROM of elbow were greater in both of the 2 groups at 24 weeks after the end of rehabilitation exercises compared to pre-rehabilitation exercises( 99. 70 +/-2. 90 vs 11. 50 +/-3. 20 degrees,t =-10. 691,P = 0. 000; 70. 50 +/-3. 20 vs 12. 10 +/-3. 10 degrees,t =-8. 738,P =0. 000),and the ROM of elbow were greater in observation group compared to control group( t = 10. 036,P = 0. 000). The recurrence of myositis ossificans was found in 1 patient in observation group and 15 patients in control group at 24 weeks after the end of rehabilitation exercises. The recurrence rate of myositis ossificans was lower in observation group compared to control group( χ~2= 15. 132,P = 0. 000).Conclusion: The rehabilitation exercises under the guidance of infrared thermography can better relieve the elbow pain,improve the ROM of elbow and reduce the recurrence rate of myositis ossificans in patients who receive release surgery for treatment of elbow myositis ossificans,so it is worthy of popularizing in clinic.更多还原