CPM在促进骨关节损伤康复中的应用研究

【作者】 姜贵云； 姚立新； 王文清； 勾丽杰； 杨晓莲；

【机构】 承德医学院附属医院康复医学科；

【摘要】 目的 CPM在促进骨关节损伤康复中的应用研究.方法 用CPM观察治疗骨关节损伤术后患者68例,治疗时间最长者4周,最短者8天,平均治疗15.6天.从疼痛、关节活动范围、骨折及组织愈合情况三个方面进行了治疗前后评价.结果 其疼痛在应用后一周左右完全消失;关节活动范围,有66例在治疗结束时关节活动度恢复正常;68例,骨折及组织均按期愈合,无感染、迁延愈合及其它并发症的发生.结论 CPM适应范围很广,经观察治疗及综合文献报导其适应症是:对骨关节骨折坚强内固定术后;各种原因致膝关节粘连、挛缩、僵硬松解术后;下肢尤其是膝关节肌腱、韧带重建或修补术后;各种原因所致的关节变形矫形术后;滑膜病变,赘生物切除术后;关节成形术后,各种异体人工假体置换术后.其作用,可尽快的促进关节功能的恢复,增加关节软骨的营养和代谢能力,刺激多能间质细胞分化成软骨,加速它以及周围组织的愈合,避免了因制动所致的肌肉萎缩、疼痛和废用性骨质疏松以及关节粘连、僵硬的发生,同时术后早期应用对促进静脉血液回流,减少软组织肿胀,有利于关节损伤的修复.在临床应用中体会到术后一周之内开始应用为宜,每天治疗2次,每次2～3小时;早期活动度不宜过大,应逐渐增加活动度,在应用后一周左右达到最大活动度;如术后在应用CPM时渗出液过多,因易致粘连和影响组织愈合,应推迟至渗出液减少时再使用.在使用中如发现有感染、深静脉血栓形成征象应停止治疗,待感染控制、血栓解后再开始使用.认为术后持续被动活动固然可使关节获得术后早期活动的机会,有效预防并发症的发生,但应及时的主动运动训练,因这种被动运动最终需由主动运动所代替,术后早期持续被动活动仅仅是关节向主动运动训练的一个过渡,主动运动才是最终恢复功能的重要措施.更多还原

【Abstract】 CPM, also called continned and passive adjustable instrument, which was used in clinical practice in the mid of 1970s, now, is applied widely to the functional recovery after the injury of bone joints, object: To study the application of CPM in improving the recovery after the injury of bone joints. Method To treat 68 patients after operation of bone joint by using CPM, last from 8 days to 4 weeks respectively, (the average is 15.6 days) .We evaluate the treatment from three aspects; the pain, the rarge of joint’s movement, the bone fracture and the recovery of the tissues. Results The pain vanished after using CPM for a week, the movement of joint retore to mormality in 66 cases, the bone fracture and injured tissues recovered in 68 cases, and without infection and other complications. Conclusion CPM can be used widely, according to clinical observation and documental reports, it can be used to these symption as followed: after the interienr consolidating operation of the bone fracture in joints, after the operation of adhesion, conctracture, and rigidness of knee - joint resulted from various reasons, after the repairing operation of tendom and ligament in knee - joint resulted from various reasons, and after the displacement of artifiaial organs. It can improve the metabolic in the joint and improve the metabolic capacities. It also can accelerate other tissues to recover quickly. In climical practice, it should be used a week later after operation, twice a day, each times for two - three hours; the movement of the joints should be in steps with the application of CPM(step by step). If there ix too much water coming out, and which leads up to adhen-sion and influencing, the recovery of tissues, not use it till no water come out, while using it, if one discover there is infections and thrombosis, stop using it till all these disappear. From the above - mentioned, we think that continued and passive movement after operation can make joints to move early, and prevent effectively the complications, at the same time, the patient should de exercises actively, for all these passive movement must be replaced by active movement which is the most important measure in recovering.更多还原