BAG DI^M T 6 N THiraNG DAY CHANG CH^O TRU'C^yC KHt^yp G 6 I VA K^T QUA PHUC H 6 | CHLfC N A N G TRONG HAI T U A N D A U CHO BENH NHAN SAU M 6 NOI SOI TAI BENH VIEN TH^ THAO VIET NAM
Nguyin Thi Nu', Le Thi Binh^' 'Bpnh vipn The thao Vipt Nam, Hd Npi
^Hpc vipn YDHCT Vipt Nam, Hd Npi
TOM TAT
Nghign CO'U m6 tS cat ngang dugc thgc hi^n tr§n 355 b^nh nhan (BN) du'gc ph§u Ihuat t^i tgo day ching ch6o tm^c t9i b#nh vi?n The thao Vi^t Nam tLr 01/05/2011 - 01/05/2012. Ngi dung d^nh gia ve ket qua cham s6c, phyc hfii chuc nang (CS-PHCN) trong 2 tuan d^u sau m6, Itit qu^ CS-PHCN dat ty le cao khi benh nhan b| ton thuang dirt day chSng ch§o den thu^n o ca dpng tSc tap du6i goi, gap goi cung nhu tgp co dui de tranh teo co vA dat ty 1$ thip ho'n khi benh nhan bj t6n thuang dirt day chang ch6o cd phoi hap. Ket qua sau 2 tuin cho thiy 83,1% d^t dugc o muc tot, 16,62% dat du'ac 6 mUc 'tnjng binh" va chi co 0,28% dat dugc 6 miKC kem, Cd sg li§n quan giOa CS-PHCN nhom t6n Ihifong dut day ching cheo don thuan voi nh6m ton ihu-ong DCCT phoi hgp, vdi p < 0,05.
Tip khoa Day ching ch^o tru'd'c, Mo noi soi, Cham s6c, phyc hoi chu'c nang I. DAT VAN DE
Dut day chang cheo trudc (DCCT) la mdt chan thuang do tai nan giao thdng, tai nan lao dgng, hay gap nhat la trong chan thuang the thao. Neu khdng dugc dieu tri cd the dan den teo-yeu ca tu dau diii, dau, thoai hoa khdp, giam chuc nang chi the. Khi bi tdn thuang, khdp gdi d tu the dudi gdi keo dai, tui cung bao hoat dich dudi ca tu dau diii, tren va canh Idi cau hi CO nit, xo hoa. Hau qua tdn thuang nay la gan tli dau diii mat dan hdi, khdng the trugt m$t canh binh thudng tren xuang diii, lam han che gap gdi, dau khdp gdi [1]. Vi vgy viec tai tao DCCT la can thiet va nen lam sdm nham phyc hdi Igl dd vimg chac ciia khdp, lap lgi chiic nang, biSn do van ddng binh thudng cua khdp gdi, tranh cac bien chung.
Tgi Australia, tdn thuang DCCT chiem khoang 1,5% sd ngudi bi chan thuang [2],[3].
Ty le bi dut DCCT khdp gdi it nhit I ikn trong ddi gap 1/3.000 ngudi dan. CJ Viet Nam chua
cd thdng ke ve ty le dirt DCCT, vdi ty le tai nan giao thdng va lao ddng nliu hien nay thi con sd udc tinh kha cao. Chi rieng Khoa chan thucmg Benh vien The Thao Viet Nam hang nam phau thuat khoang 400 -500 ca. Vai trd ciia dieu dudng (DD) trong qua trinh cham sdc phuc hoi chirc nang sau phau thuat tai tao dirt day chang cheo trudc cd vai trd rat quan trong, giiip benh nhan sau md nhanh phuc hdi lay lai chiic nang de sdm hda nhap xa hdi. Theo Tran Hoang Tiing va Ngd van Toan (2011) viec tap luyen sau md tai tao day chang cheo trudc qua ndi soi khdng theo hudng dan cua bac sy, dieu dudng cd nguy ca ket qua xau gap 10,2 lan so vdi tap cd hudng din [4]. Bui Xuan Thang (2005) ap dung cach tap luyen cua Shelboume KD va Nitz, cd dieu chinh va kiem soat de phii hgp dieu kien Viet Nam thay rang cimg dugc ap dung nhiet tri lieu (parafTine) va dien xung trong giai doan bat ddng khdp gdi (2 tuan dau) sau md ngi soi tai tgo day chang cheo trudc khdp gdi, thi nhdm dugc tap van ddng tn lieu
* Tac gia: Le Thi Binh
Dia chi: Hgc vien YDHCT Viet Nam, sd 2 Dudng Tran Phu, Ha Ndi
Dien thogi: 0915004470 Eraail: [email protected]
Ngay nhan bai: 25/2/2013 Ngay giri phan bien: 28/2/2013 Ngay dang bai: 5/5/2013
Tgp chi Y hgc du phdng. Tap XXlll, sd 2 (138) PHU BAN
ngay cd mirc dg phyc hdi chirc nang tdt han [5].
De gdp phfln nang cao chat lugng dieu tn, van da CS-PHCN cho BN 2 tuan dku ngay sau phau thuat tai BV ddng vai ird rai quan trgng nham dem Igi kcl qua tdt nhat cho BN, sdm trd vc sinh hoat lai cgng ddng. Tuy nhicn khi CS-PHCN khdng diing ky thuat, cham sdc chua tdt, khdng theo diing quy dinh lam cho BN ngng len, keo dai thdi gian didu (n, chi phi cho dicu in tang len, cd Ihc gay bicn chirng, ban che vgn dgng trong cudc sdng [4],[5]. De dap irng dugc nhu cau thuc ticn cham sdc. dc tin tiSn hanh vdi muc ticu
1. Md ta dac diem dich tc hgc va lam sang ciia tdn thuang day chang cheo trudc tren bgnh nhan dugc md ngi soi dirt dirt day chang cheo trudc khdp gdi tgi Bgnh vign The thao Vigt Nam.
2 Md ta ket qua cham sdc-phuc hdi chirc nang tdn thuang day chang cheo trudc khdp gdi sau mo noi soi.
II. P H U O N G PHAP NGHIEN ClTU 2.1. Doi tugng nghien ciiu: Gom 335 ngudi benh nam dieu trj phau thuat tai tgo day chang cheo trudc tai Benh vien The thao Viet Nam tir 01/05/2011 -01/05/2012
2.2. Phuvng phfip nghien CIJU: Day la nghien cihl md ta cat ngang.
2.3. Ky thu^t ch^n mau: Chgn BN tai khoa chan thuang Bgnh vign Thd thao Viet Nam. Cac BN bi tdn thuang DCCT dugc chia 2 nhdm:
Tdn thuang dan thudn va ton thuang phdi hop 2.4. Cac bien nghien cihi: Tudi, gioi, nghe nghigp, thdi gian chd md, nguyen nhan chan thuang, vi tri chfln thuang, phan logi thuang tdn.
- Sy cham sdc phyc hdi chiic nang sau md lai tao DCCT de Ifly lai chirc nang hogt dgng ciia khdp gdi dugc danh gia dira vao bang theo ddi hang ngay cac dflu hieu LS (dflu hieu co nang, thuc the...)
- Cac bien nghien ciru lien quan nhu: dudi khdp gdi, gap khdp gdi, teo ca dui cung dugc thu thgp trong ciing bang theo doi hang ngay, 2.5. Phirong phap thu thap so li^u: Bang theo ddi BN da dugc thiet ke dua tren myc tieu NC va da dugc cac chuyen gia. Bang theo ddi da dugc dien vao bdi thanh vien nghien ciiu.
2.6. Xu !>' sd lieu: Sd lieu dugc phfln tich bang phfln mem SPSS 16.0 de tinh ty le phfln tram, trung binh, mdi lien quan giira cac bien.
I I I . K E T Q U A
3.1. Dac diem chung cua doi tumig nghien cthi Bang 1. Dac diem djch te hoc ciia b^nh nhan bj ton thu>o^g DCCT Dac diem nghien cuu So luo'ng (n = 355) Ty l9 %
<20 2 0 - 2 9 3 0 - 3 9 4 0 - 4 9
>50 Gicri tinh
Nam Hi Nghe nghidp
The dye the thao N6ng dan Nganh nghe l^h^c (cong nhan, bu6n ban ..) Nguyen nhSn gay ton thifong DCCT
Tai nan giao thong Tai ngn sinh hoat Tai nan the di^ic the thao Tai nan lao dgng
46 202 70 24 13 274 81
54 82 219
84 29 220 22
13 56.9 19,7 6.7 3,7 77,2 22,8
15,2 23,1 61,7
23,7 8,2 61,9 6,2 Tap chi Y hgc dir phong, Tap XXIII, so 2 (138) PHU BAN
Bkng 1 cho thay, nhom tudl chiem ty I.e cao nhflt 20-29 (56,9%), thap nhflt > 50 tu6i(3,7%), Nam cao hon nii gidi (77,2). "nganh nghe khac"
chi6m cao nhflt (61,7%), nguySn nhan gfly tdn
thuang cao nhat tai nan do thg dye th6 thao (61,9%) va thflp nhflt do tai ngn lao ddng (6,2%) 3.2. Cac bieu hifn )am sang khi vao vien ciia b^nh nhan bj ton thuong DCCT Bing 2. Bilu hifn lam sang cua benh nhan bj ton thuo'ng DCCT
Bien so nghien CLFU
Tfnh chat - vj tri ton thucng DCCT T6n thuang dan thu^n
Ton thuong phdi hgp
Thd'i gian chv phau thugt
<12thang 1 2 - 2 4 thang 24 - 36 thang
> 36 thang Cac dau hi#u lam sang khi vao vien Ldng khdp Mat vung Dau hieu Lachman Dau hieu ngan keo trLFdc
S6 luc^ng (%)
264 (74,35)
91 (25,65)
Don thuan 127 (36%) 100 (28%) 19(5%) 18(5%) So lug'ng (%) 312 (87,9) 341 (96,1) 337 (95,0) 339 (95,5)
Vjtri
Ben phai Ben trai Ben phai Ben trat Phoi ho'p 40(11%) 35 (10%) 9 (3%) 7 (2%)
So luong (%)
136(38,3) 128(36,05) 47(13,25) 44 (12,4)
Bang 2 cho thay, t6n thuong don thujn (11%), flip den ty le thjp din. Dau hieu long chigm cao hon nhom tdn thuong phoi hop khop thSp hon dau hieu mat vung (87,9% so voi (74,35% so voi 25,65%). Vi tri tdn thuang ben 96,1 %). DSu hieu Lachman tuong duong voi phai cao hon ben ti^i 6 ca 2 nhom thuong tdn. diu hieu ngan keo tntoc (95% so voi 95,5%) Thoi gian cho phlu thuat cao nhdt < 12 thang 3.3. Ket qua Cham soc, phuc hoi chirc nang 2 doi voi ca 2 nhom don thuan (36%) va ph6i hop tuan dau sau mo tai tao DCCT
Tap chi Y hpc du phbng. Tap XXIII, so 2 (138) PHU BAN
Bang 3. Ket qud vk t$p v^n dpng cCia b$nh nhSn 2 tuin dau sau mfi n0l soi tdl t^o DCCTT Kit qua vgn d^ng sau CS-PHCN S6 luyng Ty 1^ % Muc dO dau sau md
V$n dOng du6i khdp gdi cua BN
V#n dOng g^p gdi cua BN
V^n ddng co 6k tranh teo co diii
Nhe VCfa N$ng T6t (0" - 5") Trung binh (6°-10") KSm(>10") T 6 1 ( 0 ° - 1 5 " ) rung binh ( 1 6 - - 2 5 ' ) Kim ( > 25") T6t (0-2cm) Trung binh (2-4cm) K6m (> 4cm)
310 38
1 336
ie 1 312 42
1 56 287 12
87,33 10,7 1,97 94,7 5,07 0,28 87,88
11,8 0,28 15,77 80.8 3,4 Bang 3 chi ro kdt qua giam dau sau md dau kem (0,28%). Tap van ddng ca de tranh teo ca nang chi cdn 1,97%. Ve tap van ddng duoi khdp dui cao nhat la muc trung binh (80,8%) thflp gdi chiem cao nhflt d muc tdt (94,7%), thap nhat nhflt la muc kem (3,4%)
la miic kem (0,28%). Vg tap van ddng gap goi, 3.4. Ket qua cham soc phyc hoi chijc nang cao nhat la muc tot (49,3%) va thflp nhflt la miic sau mo theo cac nhdm ton thutmg DCCT
Bang 4. So sanh ket qud tap van dong cho benh nhSn sau mo DCCT theo cac nhom ton thvang
Ket qua PHCN sau mo DCCT
TT don thuan TT phoi h^rp S6 luong (%) Sd luyng (%) Tap van dong duoi khvp goi
Tot (0° - 5') Trung binh (6"-10"
Kem(> 10") Tap v^n dpng gap go!
T4t(0°-15") Trung binh (16"-25") K6m( > 25°) Tap v^n dpng trdnh teo ca diii
T 6 | (0-2cm) Trung binh (2 - 4cm) K6m ( > 4cm)
260 (73,24) 4(1.13)
0 (0,0)
232 (65,35) 32 (9.0)
0,0
46(12,96) 213(60,0) 5(1,4)
Mi>c dp CS-PHCN trong 2 tuan dau sau mo npi soi tai t90 DCCT Tot
Trung binh Kem
295 59 1
76(21.41) 14 (3,94) 1 (0,28)
80 (22,55) 10(2,82)
1 (0,28)
10 (2,81) 74 (20,84) 7(1,97)
83,1 16,62 0,28 Tap chi Y hoc du phong. Tap XXIII, s6 2 (138) PHU BAN
Bang 4 cho biet, dudi gdi d nhdm tdn thuang don thufln tdt han nhdm tdn thuang phdi hap:
raiic tdt la 73,24% so vdi 21,46%, sg khac bi?t CO y nghia thdng ke vdi p < 0,05. Ve gflp gdi, mac du chua tim thay su khac bi?t giua tdn thuang don thufln va tdn thuang phdi hgp nhung d miic tdt chiSm ty le cao nhat d tdn thuang dan thufln (65,35%). Van dpng de tranh teo co dui, cao nhat miic trung binh ke ca 2 nhdm tdn thuang (60%
so vdi 20,84%), su khac biet cd y nghTa thdng ke vdi p < 0,05. Mirc dp CS-PHCN trong 2 hjan dflu sau md noi soi tai tgo DCCT cho thay, ket qua miic tdt cao nhat (83,1%) diap nliat la muc kem chico 0,28% vdi p < 0,05.
IV. BAN LUAN
4.1. Chpn dia diem va doi tu<^g nghien cuu:
Chiing tdl da chpn khoa Chfln thuang cd nhung dac trung gidng nhau ve tinh trang benh tat cung nhu phuang thirc dieu tri va cham sdc benh nhan. Tieu chufln lira chpn ddi tirang vao nghien Cliu nay la BN sau md ndi soi tai tao DCCT 4.2. Dac diem BN 2 tuan dau sau md noi soi tai t^o day chang cheo trudc
Dac diem chung: Benh nhan nhdm tudi 20- 29 chidm ty le cao nhflt (56,9%) day la dp mdi thudng xuyen phai tham gia giao thdng (di hpc, di lam...) hoac luyen tap the due the thao (TDTT). Nam gidi cao hem niJ (77,2 % so vdi 22,8 %), didu nay cd the ly giai rang, nam gidi da sd tham gia TDTT hoac lao dpng van chuyen, di lgi tren dudng vdi tinh chat di nhanh, vuat flu dan den de hi tai nan giao thdng kem theo tdn thuang DCCT. Nhdm cac nganh nghe khac (61,7%) la tdng hap ciia mpi nganh nghe ma phai lam viec chinh de nudi sdng gia dinh, do vgy trong qua trinh lflm viec cung phai di lai nhiSu tren dudng hoac tai nan lao ddng nghd nghiep, vi le dd gfly nen tdn thuang DCCT.
Nguyen nhan gay tdn thuang do TDTT cao nhflt (61,9%) bai hp chai theo thudng quy, tfln suflt nhi^thi ty le rui ro tai nan se cao [2],[3],[6].
Dau hieu lam sang khi BN vao vien: Cao nhit la ton thuang dan thufln (74,35%), cdn lai bi tdn thuang phdi hap vin ckc tdn thuang sun chem, day chang ben va day chang cheo sau (25,65%). Tdn thuang dan thuin la chfln
thuang gfly ra chii y6u khi chai tha thao, tai ngn cac dpng tac true tiep tham gia vao ca chS xofln van DCCT ma khdng cd cac tdn thuang khac kem theo, Tdn thuang d ben phai cao han ben trai d ca 2 nhdm. Dieu nay cd the ty giai nhu sau: trong cac hogt dpng lao dpng, dac biet trong the thao, vgn ddng chii dpng ca hai chfln, nhung chan phai thudng la thugn nen khi bi trupl chan hay gay tdn thuang ben phai hon.
Dau hieu Lachman tuong duang dau hieu ngfln keo trudc (95% so vdi 95,5%), khdp goi dang bi tran dich, sung dau (d thdi ky man tinh) tneu chiing dien hinh nhu Idng khdp chiem (87,9%), mflt virng chiem (96,1%) chuc nang van ddng khdng binh thudng bdi dau khdp gdi va sung to, cang cirng. Dau hieu nay la dieu hien nhien benh nhan phai chap nhan khi xay ra chan thuang tai dau gdi [ I ],[5],[7].
Thdi gian chd phau thuat: Ty le cao nhflt <
12 thang ddi vdi ca 2 nhdm dan thuan (36%) va phdi hop (11 %), tilp den cd ty le thap dan theo nhdm thdi gian ddi vdi ca 2 nhdm TT.
4.3. Ket qua cham soc-phuc hoi chirc nang 2 tuan sau mo tai tao DCCT
Cam giac dau: BN giam han dau d muc nang (1,97%) va chi cdn dau d miic nhe (87,33%).
Ket qua tap van ddng duoi khdp gdi sau md:
Cao nhat d miic tdt (94,7%) Dieu nay cd the giai thich rang, su CS-PHCN sdm cd vai trd rat quan trpng giiip khdp gdi viing, van ddng de dang, cho phep BN duac chai lai the thao. Tuy nhien theo Tran Hoang Tiing, Ngd Van Toan (2011) tap luyen khdng theo hudng din cd nguy ca ket qua xflu so vdi tap cd hudng dan [4].
Ket qua tap van ddng g4p gdi sau md tdn thuang DCCT Cao nhflt mirc tdt (87,88%), miic kem chi 0,28% hi chay mau khdp gdi, mac dil dupc xu ly tdt, qua born rua cam mau nhung vfln chira thd van ddng duac. Ket qua nghien ciru ciia chiing tdi ciing phii hap vdi cua Biii Xuan Thang (2005), sau CS-PHCN tflm van ddng gap khdp gdi dat 86.96% [5]
Kdt qua tap van ddng ca de tranh teo ca diii:
Cao nhflt mirc tmng binh (80,8%), mirc tdt chi dat 15,77%, miic kem cd 3,4% bdi BN trong thdi ky di chiing do giam van ddng khdp gdi thdi gian dai cd hien tupng teo co diii trudc khi phflu thuflt [4].
Tap chi Y hpc du phdng. Tap XXIII, sd 2 (138) PHU BAN
4.4. So sanh liet qua tap van dgng sau mo DCCT theo cac nhom t6n thuang
va duoi khdp gdi: Kha nang dudi goi a nhdm tdn thuang don thuan tdt han d nhdm tdn thuang phoi hpp d mirc tdl 73,24% so ydi 21,41 % (Bang 4), sv khac bici cd y nghTa thong k e v d i p < 0.05.
Gap gdi: Bang 4 cho thay, tdn thuang dan ihufln cd ty lc cao han tdn thuang phdi hpp d cac mirc. Dieu nay cd the ly giai rang, neu ldn thuang nhe BN sc kien tri tap van dpng sdm han khl cd nhidu TT tran ca the (dau ddn 1^ ly do van ddng it hem) vdi p > 0,05. Nghien ciru ciia Biii Xufln Thflng (2005) cung phii hap kdt qua cua chiing tdi ket qua giam dan tir mirc tdt den miic kem) [5].
Van ddng ca de tranh teo ca diu: Kdt qua cho thfly (Bang 4) tdn thuang dan thufln cao hon tdn thuang phdi hap d cac mirc, mirc kem thi tdn thuang phdi hgp lgi chiem cao han ldn thuang dan thuan (do thdi gian dai chd md da cd hien tugng teo ca diii) [4], vdi p < 0,05.
Mlic dp chung PHCN khdp gdi cua NB trong 2 tufln dau sau md' Miic tdt (81,3%), trung binh (16,62%), mirc kem chi 0,28%. Dfly la kat qua CS-PHCN sdm sau md cho BN dat v6 gflp gdi, duoi gdi, ca din se giiip BN sdm Ifly lai chiic nang khdp gdi de sdm ve cpng ddng [5].
V. K E T LUAN
Dau hieu lam sang cua BN bj tdn thuong day chang cheo trudc:
- Nhdm tdn thuang dan thufln cao han tdn thuang phdi hgp (74,35% so vdi 25,65%)
- Vi tri tdn thuang. ban phai chiem ty le cao hon ben trai.
- Thdl gian chd phflu thuflt chiem ty le cao nhflt < 12 thflng (11%). tidp ddn 12-24 thang (10%), sau dd tir 24-36 thang (3%) va ty le thap nhflt > 36 thang (2%).
- Dau hieu mat viing chiem ty le cao nhflt (96,1%) sau dd den dflu hieu Lachman va dflu hieu ngan keo trudc (95 va 95,5%). va ty le thflp nhat lfl dflu hieu ldng khdp (87,9%).
Ket q u i CS - PHCN ton thmmg DCCT khdp goi trong 2 tu4n dau sau mo ngi soi.
- Mlic dau sau 2 tu^n, d mirc nh? chi cdn 87,33 %, dau d miic ngng chi cdn 1,97%.
- va van dpng: dudi khdp gdi miic tdt dat 94,7%, vd gap goi miic tot dat 87,88%, van dpng ca dd tranh teo ca dui miic tot dat chi dat 11,77%. . . - Ket qufl chung CS-PHCN sau 2 tufln dau:
mirc tdt (81,3%), mure kem chi cd 0,28% (p
<0,05).
KIIUVKN N ( ; H !
Bdnh nhfln sau md tai tao DCCT khdp goi cfln tap vfln dpng sdm se nhanh chdng phuc hdi.
TAI L l K l THAIVI K H A O
1. Ha Dire Cuong (2011), Giai phflu va vai trd cua dfly chflng cheo trudc, www.hospi- talvnpt.com.vn/u=con&cid=158l&t=l.
2. Nguyen Dinh Chucmg (2010), Didu tri bong nai bam chay dfly chflng cheo trudc bang ky thuat khflu cd dinh dudi npi soi, Ngoai khoa sd 4-5-6/2010.
3. Dd Ngpc Hidu, Nguyin Hiru Tii (2005), Nghien ciiu dflc didm djch te thuang tich do tai nan cua BN khi vao vien, lien quan den dp nang chan thuang, Tgp chi nghien cihi y hgc, tap 39. sd 6. DHY Ha Ndi, tr 71.
4. Trfln Hoang Tung, Ngd Van Toan (2011), Phau thuflt npi soi dieu tri tai tgo DCCT khop gdi bang gfln ca thon va gan co ban gan tu thfln, Tgp chi nghien ciiu Y hgc phu truang 74(.'t)-2011, trang 196 - 200.
5. Bui Xuan Thflng (2005), Danh gia kdt qua PHCN khdp gdi sau phau thuflt tai tgo day chang cheo trudc qua ngi soi, Luan van tdt nghiep Bac sy chuyen khoa cap II, tr 35 6. Nguyen Xufln Nghien (2002), Van dgng tn
lieu. Vat ly tri lieu - Phuc hdi chiic nang, NXB Y hpc, trang 277 - 287.
7. Spindler KP (2004) Anterior cruciate liga- ment reconstruction autograft choice: Bone- Tendon-Bone versus Hamstring" Am J Spost Med 32(8),pp.l986-1995.
Tap chi Y hgc du phdng. Tap XXlll, sd 2 (138) PHU BAN
CHARACTERISTICS OF THE ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS OUTCOMES OF REHABILITATION AFTER 2-WEEK OPERATION IN THE VIETNAM SPORT HOSPITAL.
Nguyen Thi Nu', Le Thi Binh^
'Vietnam Sport hospital, Hanoi
^VietnamUniversiity of Traditional Medicine, Hanoi We carried out a retrospective study in
which 335 patients were enrolled at the Depart- ment in Viet Nam Sport Hospital. The partici- pants had antenor cruciate ligament injuries admitted to the hospital from 01/May/2011 to
l/Dec/2012. The objectives- (I) To describe the characteristics of the disease after operation of anterior cruciate ligament and (2) To describe the outcomes of rehabilitation of the anterior cruciate ligament injuries, some associated fac- tors to the anterior cruciate ligament injuries on
Viet Nam Sport Hospital. The results showed that, after 2 weeks of operation, most of the pa- tients having injury of the Anterior cruciate lig- ament restored the functions at good level (81,3%), moderate level (16,62 %), bad level only 2,8%. This result was one of the important factors associated with their nursing care prac- tices.
Key words: Anterior cruciate ligament, in- jure, nurses, patients, care, restore functions.
Tap chi Y hpc du phdng. Tap XXIII, sd 2(138) PHU BAN
