髋关节置换术后患者早期康复锻炼有利于髋关节功能的恢复
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摘要
为探讨早期康复锻炼对髋关节置换患者肢体功能和生活质量的影响,本研究选取2016年5月至2017年5月期间在重庆市九龙坡区人民医院行髋关节置换术的患者156例,按照随机数字表法均分为试验组和对照组,每组78例。对照组患者给予常规康复及护理,试验组患者采用心理、康复指导训练并制定个体化的康复方案进行早期康复锻炼。比较两组患者治疗前后Barthel指数及Harris积分,评价肢体功能恢复质量。结果表明,两组患者治疗后Barthel指数,试验组为80.15±17.63,对照组69.15±11.34;治疗后Harris积分,试验组90.36±8.41,对照组73.42±10.98,试验组优于对照组,差异有统计学意义(p<0.05)。试验组术后深静脉血栓发生率为2.46%,感染发生率为7.58%,髋关节脱位发生率为0%,并发症的发生率为17.43%,均低于对照组,差异有统计学意义(p<0.05)。试验组患者在生理健康水平得分(89.42±4.29)、心理健康水平得分(82.37±4.93)、独立能力水平得分(71.69±6.14)以及社会支持得分(68.49±4.11)等方面的得分均明显高于对照组,差异有统计学意义(p<0.05)。本研究初步表明,早期康复锻炼有利于髋关节置换术后患者髋关节功能的恢复,可减少并发症的发生,提高生活质量。
In order to explore the effect of early rehabilitation exercise on the limb function and quality of life in patients with hip replacement. 156 cases of hip arthroplasty in Chongqing Jiulongpo People's Hospital from May2016 to May 2017 were selected in this research, and divided into the experimental group and the control group according to the random number table method, with 78 cases in each group. The control group received routine rehabilitation and nursing. The experimental group received psychological rehabilitation guidance training and individualized rehabilitation plan for early rehabilitation exercise. The Barthel index and Harris score of the two groups were compared before and after treatment to evaluate the quality of the recovery of limb function. The results showed that: The Barthel index of the two groups after treatment was 80.15 ±17.63 in the experimental group and 69.15±11.34 in the control group. The Harris score after treatment was 90.36±8.41 in the experimental group and 73.42±10.98 in the control group. The experimental group was better than the control group, and the difference was statistically significant(p<0.05). The incidence of deep venous thrombosis was 2.46%, the incidence of infection was 7.58%, the incidence of hip dislocation was 0%, and the incidence of complications was 17.43%in experimental group, the difference was statistically significant(p<0.05). The scores of the patients in the experimental group were scored in the physiological health level(89.42±4.29), the mental health level score(82.37±4.93), the independent ability level score(71.69±6.14), and the social support score(68.49±4.11), were significantly higher than the control group, and the difference was statistically significant(p<0.05). This study initially indicated that:early rehabilitation exercise is beneficial to the recovery of hip joint function after hip replacement, it could prevent the occurrence of complications and improve the quality of life.
In order to explore the effect of early rehabilitation exercise on the limb function and quality of life in patients with hip replacement. 156 cases of hip arthroplasty in Chongqing Jiulongpo People's Hospital from May2016 to May 2017 were selected in this research, and divided into the experimental group and the control group according to the random number table method, with 78 cases in each group. The control group received routine rehabilitation and nursing. The experimental group received psychological rehabilitation guidance training and individualized rehabilitation plan for early rehabilitation exercise. The Barthel index and Harris score of the two groups were compared before and after treatment to evaluate the quality of the recovery of limb function. The results showed that: The Barthel index of the two groups after treatment was 80.15 ±17.63 in the experimental group and 69.15±11.34 in the control group. The Harris score after treatment was 90.36±8.41 in the experimental group and 73.42±10.98 in the control group. The experimental group was better than the control group, and the difference was statistically significant(p<0.05). The incidence of deep venous thrombosis was 2.46%, the incidence of infection was 7.58%, the incidence of hip dislocation was 0%, and the incidence of complications was 17.43%in experimental group, the difference was statistically significant(p<0.05). The scores of the patients in the experimental group were scored in the physiological health level(89.42±4.29), the mental health level score(82.37±4.93), the independent ability level score(71.69±6.14), and the social support score(68.49±4.11), were significantly higher than the control group, and the difference was statistically significant(p<0.05). This study initially indicated that:early rehabilitation exercise is beneficial to the recovery of hip joint function after hip replacement, it could prevent the occurrence of complications and improve the quality of life.
引文
Feng Y.Z.,Huang S.Z.,Chen W.Z.,Yu J.H.,He L.L.,Pan Y.C.,and Li L.Y.,2017,Operating room nursing strategy and effect of total hip arthroplasty,Guangdong Yixue(Guangdong Medical Journal),(S2):186-187(冯银珍,黄素珍,陈卫珍,余建华,何利雷,潘耀成,李留夷,2017,全髋关节置换术的手术室护理策略及效果,广东医学,(S2):186-187)
Lee M.,Moorhead S.,and Clancy T.,2014,Determining the cost-effectiveness of hospital nursing interventions for patients undergoing a total hip replacement,Journal of Nursing Management,22(7):825-836
Li Y.,Yuan Y.H.,Yang F.M.,and Ding Z.J.,2009,The effect of psychological intervention in perioperative period of hip arthroplasty patients,Guangdong Yixue(Guangdong Medical Journal),30(10):1585-1586(李怡,袁月环,杨芳梅,丁志军,2009,心理干预在髋关节置换术患者围手术期中的作用,广东医学,30(10):1585-1586)
Liu W.Y.,Yan G.H.,and Zhang X.H.,2007,Rehabilitation care after total hip revision,Zhongguo Jiaoxin Waike Zazhi(Orthopedic Journal of China),15(4):311-312(刘文英,闫桂虹,张秀辉,2007,全髋关节翻修术后的康复护理,中国矫形外科杂志,15(4):311-312)
Wang Q.M.,2017,Effect of health education process on rehabilitation of patients undergoing artificial hip replacement,Zhongguo Jiankang Jiaoyu(Chinese Journal of Health Education),33(7):648-651(王琴敏,2017,健康教育流程对人工髋关节置换术患者康复的应用效果,中国健康教育,33(7):648-651)
Xiong W.,Li F.,Xia R.Y.,and Chen A.M.,2004,A doctor-patient survey of exercise recovery after total hip replacement,Zhongguo Jiaoxin Waike Zazhi(Orthopedic Journal of China),12(1):128-130(熊伟,李锋,夏仁云,陈安民,2004,全髋关节置换术后运动恢复的医患调查,中国矫形外科杂志,12(1):128-130)
Yu S.M.,Hu J.Y.,Huang S.H.,Xu D.L.,and Zeng X.S.,2006,Effect of early systemic functional training after total hip arthroplasty in 178 patients,Guangdaong Yixue(Guangdong Medical Journal),27(6):853-854(余世明,胡俊勇,黄少华,徐栋梁,曾宪尚,2006,178例全髋关节置换术后早期系统化功能训练效果,广东医学,27(6):853-854)
Zong S.J.,Wang F.,and Hu S.L.,2016,Total hip replacement for developmental dysplasia of hip and postoperative nursing,J.Biol.Regul.Homeost.Agents.,30(1):173-179
Lee M.,Moorhead S.,and Clancy T.,2014,Determining the cost-effectiveness of hospital nursing interventions for patients undergoing a total hip replacement,Journal of Nursing Management,22(7):825-836
Li Y.,Yuan Y.H.,Yang F.M.,and Ding Z.J.,2009,The effect of psychological intervention in perioperative period of hip arthroplasty patients,Guangdong Yixue(Guangdong Medical Journal),30(10):1585-1586(李怡,袁月环,杨芳梅,丁志军,2009,心理干预在髋关节置换术患者围手术期中的作用,广东医学,30(10):1585-1586)
Liu W.Y.,Yan G.H.,and Zhang X.H.,2007,Rehabilitation care after total hip revision,Zhongguo Jiaoxin Waike Zazhi(Orthopedic Journal of China),15(4):311-312(刘文英,闫桂虹,张秀辉,2007,全髋关节翻修术后的康复护理,中国矫形外科杂志,15(4):311-312)
Wang Q.M.,2017,Effect of health education process on rehabilitation of patients undergoing artificial hip replacement,Zhongguo Jiankang Jiaoyu(Chinese Journal of Health Education),33(7):648-651(王琴敏,2017,健康教育流程对人工髋关节置换术患者康复的应用效果,中国健康教育,33(7):648-651)
Xiong W.,Li F.,Xia R.Y.,and Chen A.M.,2004,A doctor-patient survey of exercise recovery after total hip replacement,Zhongguo Jiaoxin Waike Zazhi(Orthopedic Journal of China),12(1):128-130(熊伟,李锋,夏仁云,陈安民,2004,全髋关节置换术后运动恢复的医患调查,中国矫形外科杂志,12(1):128-130)
Yu S.M.,Hu J.Y.,Huang S.H.,Xu D.L.,and Zeng X.S.,2006,Effect of early systemic functional training after total hip arthroplasty in 178 patients,Guangdaong Yixue(Guangdong Medical Journal),27(6):853-854(余世明,胡俊勇,黄少华,徐栋梁,曾宪尚,2006,178例全髋关节置换术后早期系统化功能训练效果,广东医学,27(6):853-854)
Zong S.J.,Wang F.,and Hu S.L.,2016,Total hip replacement for developmental dysplasia of hip and postoperative nursing,J.Biol.Regul.Homeost.Agents.,30(1):173-179