术后早期康复训练对高龄髋关节置换患者功能恢复的影响

Evaluation of an early postoperative rehabilitation program for elderly hip replacement patients

目的探讨术后早期康复训练对高龄髋关节置换患者功能恢复的影响。方法共选取95例髋关节置换患者，根据患者年龄将其划分为高龄组（年龄〉／80岁）及非高龄组（年龄〈80岁）。于手术前发给每位患者一本康复指导手册，主要向患者介绍手术前后康复训练要点。在康复医师指导下，2组患者于手术前后参照该手册进行早期康复训练。本研究于术前及术后6个月时分别采用WOMAC量表和SF-36量表对患者髋关节功能及全身健康状况进行评定。结果2组患者在治疗过程中无一例发生栓塞性并发症。通过比较WOMAC评分结果发现，2组患者髋关节疼痛、功能、僵硬情况均较治疗前明显改善（均P〈0．05），除高龄组患者术后6个月时髋关节僵硬评分显著优于非高龄组外（P〈0．05），其它各项指标组间差异均无统计学意义（P〉0．05）；比较SF-36评分结果发现，2组患者健康状况均较治疗前明显改善（均P〈0．05），除情感职能、精神状态评分2组间差异有统计学意义外（P〈0．05），其余各项指标组间差异均无统计学意义（P〉0．05）。结论术后早期康复训练对高龄及非高龄髋关节置换患者疗效相当，均能显著促进患者术后髋关节功能恢复。

Objective To evaluate the effect of early postoperative rehabilitation on functional recovery of elderly patients post hip replacement. Methods Ninety-five patients who had received primary hip replacement were included in this study. They were divided into an elderly group （age≥80 years） and a non-elderly group （ 〈 80 years）. Before the operation each patient was given a guidebook describing the rehabilitation program during the hospitalization period pre-operation and post-operation. Guided by a therapist, the patients＇ rehabilitation training was carried out in accordance with the guidebook. Patients were evaluated immediately prior to surgery and 6 months postoperation. Hip function and health-related quality of life were evaluated with self-administered WOMAC and SF-36 health questionnaires. Results None of the patients suffered post-operative pulmonary embolism or other complications. Comparing the WOMAC scores of the two groups, hip pain, function, and stiffness were all improved in both groups. There were no significant age-related differences, except that the patients in the elderly group reported less hip stiffness at 6 months post-operation. The SF-36 scores in the two groups showed that health-related quality of life improved. There were no significant differences between the physical component scores or mental component scores of the 2 age groups. Conclusion The effects of early post-operative rehabilitation on aged patients were similar to those with younger patients. Early postoperative rehabilitation can improve functional recovery in both aged and younger patients.