CAJ | 학술논문

目的探讨早期床旁运动疗法对全髋关节置换(totalhiparthroplasty，THA)术后康复的影响。方法回顾性分析2012年6月至2013年7月，我院骨科首次接受THA手术治疗的86例，分为观察组和对照组，每组43例。观察组采用早期床边运动疗法治疗，对照组采取卧床休息、药物止痛等传统保守治疗及指导患者训练。记录首次下床时间和住院天数。采用 Harris 髋关节功能及 MBI 评分评定患者的髋关节功能恢复状况及日常生活活动自理能力，并记录治疗前及治疗后1周的Harris和MBI评分。结果治疗后1周观察组髋关节功能及日常生活活动能力具有明显改善，Harris 及 MBI 评分分别由治疗前(43.65±4.82)分、(34.22±12.15)分提高到治疗后1周的(69.85±12.26)分、(50.52±15.36)分，且两组评分治疗前、后差异均有统计学意义( P＜0.05)；而对照组治疗后髋关节功能及日常生活活动能力较治疗前变化不大( P＞0.05)；治疗后1周观察组Harris及MBI评分分别高于对照组Harris评分(50.52±11.34)分、MBI评分(38.13±11.27)分，且差异均有统计学意义( P＜0.05)。观察组的首次下床时间(4.67±3.24)天和平均住院日(16.4±1.0)天分别小于对照组(15.33±6.12)天和(17.6±1.2)天，差异均有统计学意义( P＜0.05)。观察组平均术后3天均可部分负重行走，出院时均可用助行器辅助行走，康复训练期间无1例发生并发症。结论早期床边运动疗法能显著改善THA患者的髋关节功能，提高其日常生活活动能力。
목적탐토조기상방운동요법대전관관절치환(totalhiparthroplasty，THA)술후강복적영향。방법회고성분석2012년6월지2013년7월，아원골과수차접수THA수술치료적86례，분위관찰조화대조조，매조43례。관찰조채용조기상변운동요법치료，대조조채취와상휴식、약물지통등전통보수치료급지도환자훈련。기록수차하상시간화주원천수。채용 Harris 관관절공능급 MBI 평분평정환자적관관절공능회복상황급일상생활활동자리능력，병기록치료전급치료후1주적Harris화MBI평분。결과치료후1주관찰조관관절공능급일상생활활동능력구유명현개선，Harris 급 MBI 평분분별유치료전(43.65±4.82)분、(34.22±12.15)분제고도치료후1주적(69.85±12.26)분、(50.52±15.36)분，차량조평분치료전、후차이균유통계학의의( P＜0.05)；이대조조치료후관관절공능급일상생활활동능력교치료전변화불대( P＞0.05)；치료후1주관찰조Harris급MBI평분분별고우대조조Harris평분(50.52±11.34)분、MBI평분(38.13±11.27)분，차차이균유통계학의의( P＜0.05)。관찰조적수차하상시간(4.67±3.24)천화평균주원일(16.4±1.0)천분별소우대조조(15.33±6.12)천화(17.6±1.2)천，차이균유통계학의의( P＜0.05)。관찰조평균술후3천균가부분부중행주，출원시균가용조행기보조행주，강복훈련기간무1례발생병발증。결론조기상변운동요법능현저개선THA환자적관관절공능，제고기일상생활활동능력。
Objective To investigate effects of early bed exercise therapy in the rehabilitation after total hip arthroplasty ( THA ).Methods The clinical data of 86 patients receiving primary THA from June 2012 to July 2013 were retrospectively analyzed, who were divided into 2 groups randomly. The patients in the experimental group (n=43 ) received early bed exercise therapy, and the patients in the control group (n=43 ) received traditional conservative therapy and training, such as resting in bed, pain relieving drug and so on. The ifrst time to get out of bed and hospitalization days were recorded. The Harris hip score ( HHS ) system was used to evaluate the functional recovery of the hip joint, and the modified Barthel index ( MBI ) to assess the self-care ability in daily activities. The HHS and MBI scores were recorded before the treatment and at 1 week after the treatment.Results At 1 week after the treatment, the function of the hip joint and self-care ability in daily activities were obviously improved in the experimental group. The HHS and MBI scores were ( 43.65±4.82 ) points and ( 34.22±12.15 ) points before the treatment, which were improved to ( 69.85±12.26 ) points and ( 50.52±15.36 ) points at 1 week after the treatment. There were statistically signiifcant differences before and after the treatment (P<0.05 ). The function of the hip joint and self-care ability in daily activities changed little after the treatment in the control group (P>0.05 ). The HHS and MBI scores in the experimental group were higher than ( 50.52±11.34 ) points and ( 38.13±11.27 ) points in the control group at 1 week after the treatment. There were statistically signiifcant differences between them (P<0.05 ). The ifrst time to get out of bed and the average day in hospital were ( 4.67±3.24 ) d and ( 15.33±6.12 ) d in the experimental group, which were shorter than ( 16.4±1.0 ) d and ( 17.6±1.2 ) d in the control group. There were statistically signiifcant differences between them (P<0.05 ). A few of the patients in the experimental group could walk with weight at about 3 days after the treatment on average, and all of them left the hospital at 15 days after the treatment and could walk with the assisted walker. No infections were noticed during the rehabilitation period.Conclusions The early bed exercise therapy can promote the recovery and improve the postoperative functions in the patients receiving THA.