中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
9期
653-656
,共4页
徐国健%翁东%谢明华%梁文清%钱宇
徐國健%翁東%謝明華%樑文清%錢宇
서국건%옹동%사명화%량문청%전우
手术前期间%健康教育%关节成形术,置换,髋%康复
手術前期間%健康教育%關節成形術,置換,髖%康複
수술전기간%건강교육%관절성형술,치환,관%강복
Preoperative period%Health education%Arthroplasty,replacement,hip%Rehabilitation
目的：探讨术前康复教育在全髋关节置换(totalhiparthroplasty，THA)中的意义。方法2012年1月至2013年1月，我科行THA的患者87例，分为实验组45例和对照组42例。对照组给予常规治疗护理，实验组给予常规治疗护理外，术前由手术医师和专科护士采用图片和影像资料结合实际练习，教育患者预先掌握功能锻炼方法。记录术后两组完成主动规范功能锻炼时间、肢体周径增量值及术后并发症发生率，并比较两组各指标组间及组内的差异。结果实验组首次主动完成踝泵锻炼时间、股四头肌等长收缩时间、直腿抬高时间分别为(4.62±2.39) h、(13.33±5.88) h、(23.67±6.01) h，分别少于对照组(6.12±2.93) h、(16.02±5.89) h、(27.95±7.85) h，差异均有统计学意义( P＜0.05)；下肢周径比较，实验组与对照组在术后第1天下肢周径增量值差异无统计学意义( P＞0.05)，但两组术后第2、3、5、7天下肢周径增量值均逐渐减少，实验组分别为(3.76±0.75) cm、(3.68±0.56) cm、(3.46±0.53) cm、(3.17±0.36) cm，分别小于对照组(4.03±0.55) cm、(3.92±0.51) cm、(3.71±0.59) cm、(3.48±0.36) cm，差异均有统计学意义( P＜0.05)；实验组术后并发下肢深静脉血栓( deep vein thrombosis，DVT )1例、感染1例，对照组术后并发下肢DVT 5例、假体脱位1例、感染5例，且实验组术后并发症发生率4.5%明显低于对照组26.2%，差异有统计学意义(P＜0.05)。结论术前康复教育可使THA患者预先掌握功能锻炼的方法、术后早期主动规范康复锻炼，明显减少首次主动规范功能锻炼的时间、减轻患肢肿胀和减少并发症的发生，值得临床推广应用。
目的：探討術前康複教育在全髖關節置換(totalhiparthroplasty，THA)中的意義。方法2012年1月至2013年1月，我科行THA的患者87例，分為實驗組45例和對照組42例。對照組給予常規治療護理，實驗組給予常規治療護理外，術前由手術醫師和專科護士採用圖片和影像資料結閤實際練習，教育患者預先掌握功能鍛煉方法。記錄術後兩組完成主動規範功能鍛煉時間、肢體週徑增量值及術後併髮癥髮生率，併比較兩組各指標組間及組內的差異。結果實驗組首次主動完成踝泵鍛煉時間、股四頭肌等長收縮時間、直腿抬高時間分彆為(4.62±2.39) h、(13.33±5.88) h、(23.67±6.01) h，分彆少于對照組(6.12±2.93) h、(16.02±5.89) h、(27.95±7.85) h，差異均有統計學意義( P＜0.05)；下肢週徑比較，實驗組與對照組在術後第1天下肢週徑增量值差異無統計學意義( P＞0.05)，但兩組術後第2、3、5、7天下肢週徑增量值均逐漸減少，實驗組分彆為(3.76±0.75) cm、(3.68±0.56) cm、(3.46±0.53) cm、(3.17±0.36) cm，分彆小于對照組(4.03±0.55) cm、(3.92±0.51) cm、(3.71±0.59) cm、(3.48±0.36) cm，差異均有統計學意義( P＜0.05)；實驗組術後併髮下肢深靜脈血栓( deep vein thrombosis，DVT )1例、感染1例，對照組術後併髮下肢DVT 5例、假體脫位1例、感染5例，且實驗組術後併髮癥髮生率4.5%明顯低于對照組26.2%，差異有統計學意義(P＜0.05)。結論術前康複教育可使THA患者預先掌握功能鍛煉的方法、術後早期主動規範康複鍛煉，明顯減少首次主動規範功能鍛煉的時間、減輕患肢腫脹和減少併髮癥的髮生，值得臨床推廣應用。
목적：탐토술전강복교육재전관관절치환(totalhiparthroplasty，THA)중적의의。방법2012년1월지2013년1월，아과행THA적환자87례，분위실험조45례화대조조42례。대조조급여상규치료호리，실험조급여상규치료호리외，술전유수술의사화전과호사채용도편화영상자료결합실제연습，교육환자예선장악공능단련방법。기록술후량조완성주동규범공능단련시간、지체주경증량치급술후병발증발생솔，병비교량조각지표조간급조내적차이。결과실험조수차주동완성과빙단련시간、고사두기등장수축시간、직퇴태고시간분별위(4.62±2.39) h、(13.33±5.88) h、(23.67±6.01) h，분별소우대조조(6.12±2.93) h、(16.02±5.89) h、(27.95±7.85) h，차이균유통계학의의( P＜0.05)；하지주경비교，실험조여대조조재술후제1천하지주경증량치차이무통계학의의( P＞0.05)，단량조술후제2、3、5、7천하지주경증량치균축점감소，실험조분별위(3.76±0.75) cm、(3.68±0.56) cm、(3.46±0.53) cm、(3.17±0.36) cm，분별소우대조조(4.03±0.55) cm、(3.92±0.51) cm、(3.71±0.59) cm、(3.48±0.36) cm，차이균유통계학의의( P＜0.05)；실험조술후병발하지심정맥혈전( deep vein thrombosis，DVT )1례、감염1례，대조조술후병발하지DVT 5례、가체탈위1례、감염5례，차실험조술후병발증발생솔4.5%명현저우대조조26.2%，차이유통계학의의(P＜0.05)。결론술전강복교육가사THA환자예선장악공능단련적방법、술후조기주동규범강복단련，명현감소수차주동규범공능단련적시간、감경환지종창화감소병발증적발생，치득림상추엄응용。
Objective To investigate the role of preoperative rehabilitation education in total hip arthroplasty ( THA ).Methods From January 2012 to January 2013, 87 patients receiving THA were randomly divided into experimental group (n=45 ) and control group (n=42 ). The patients in the control group received conventional treatment and care. Besides that, the patients in the experimental group grasped the functional training method before the operation under the guidance of surgeons and specialist nurses by using the pictures and videos combined with practical exercises. The duration of the active and standard functional exercises for the ifrst time, incremental value of limb circumference and postoperative complication rates were recorded in both groups, and the differences between them were compared.Results The duration of the active ankle pump exercises for the ifrst time, contraction time of the musculi quadriceps femoris and straight leg raising time were ( 4.62±2.39 ) hr, ( 13.33±5.88 ) hr and ( 23.67±6.01 ) hr respectively in the experimental group, which were shorter than ( 6.12±2.93 ) hr, ( 16.02±5.89 ) hr and ( 27.95±7.85 ) hr in the control group. There were statistically signiifcant differences between the 2 groups (P<0.05 ). No statistically signiifcant differences in the incremental value of the lower limb circumference existed at 1 day after the operation between the 2 groups (P>0.05 ). However, the incremental values of the lower limb circumference were gradually reduced at 2, 3, 5 and 7 days after the operation, which was ( 3.76±0.75 ) cm, ( 3.68±0.56 ) cm, ( 3.46±0.53 ) cm and ( 3.17±0.36 ) cm in the experimental group and ( 4.03±0.55 ) cm, ( 3.92±0.51 ) cm, ( 3.71±0.59 ) cm and ( 3.48±0.36 ) cm in the control group. There were statistically significant differences between the 2 groups (P<0.05 ). There was 1 case of deep vein thrombosis ( DVT ) of the lower limb and 1 case of infections in the experimental group, and there were 5 cases of DVT of the lower limb, 1 case of prosthesis dislocation and 5 cases of infections in the control group. The postoperative complication rate was obviously lower in the experimental group ( 4.5% ) than that in the control group ( 26.2% ), and there were statistically significant differences between the 2 groups (P<0.05 ).Conclusions The preoperative rehabilitation education in THA is worthy of clinical application, with the advantages of obviously alleviated limb swelling and lower complication rates. The patients can grasp the functional training method in advance, so as to actively standardize rehabilitation exercises early.
