早期康复干预对老年人股骨粗隆间骨折手术治疗后的疗效影响

Efficacy of early rehabilitation in elderly patients with intertrochanteric femoral fractures underwent operation

目的探讨早期康复干预对老年人股骨粗隆间骨折手术疗效的影响。方法选取60例股骨粗隆间骨折的老年患者分为两组，康复组（30例）与对照组（30例），两组患者均予微创Gamma钉内固定处理，其中康复组术前、术后皆用综合康复训练；对照组患者仅让其术后自行遵医嘱进行功能锻练。术后两组患者定期随访，比较两组间的疗效。结果经过5～36个月（平均21个月）的随访，两组患者均获得骨性愈合，其中康复组愈合时间为（3±0．5）个月，对照组愈合时间为（3．2±0．4）个月，两组间的差异无统计学意义（t=0．435，P〉0．05）。康复组术后并发症的发生率为13．3％，对照组的为30％，两组间的差异有统计学意义（X^2=8．755，P〈0．01）；康复组术后的优良率为91．6％，而对照组的为80．2％，两组间的差异有统计学意义（X^2=8．984，P〈0．01）。结论微创Gamma钉内固定治疗老年人股骨粗隆间骨折能获得可靠固定，系统的康复治疗是保证疗效的重要措施，有助于加快患者术后功能康复，提高生活质量。

Objective To evaluate the efficacy of early rehabilitation training on intertrochanteric femoral fractures in elderly patients after operation. Methods 60 cases with intcrtrochanteric femoral fractures were divided into rehabilitation （30cares） and control group（30cares）. All the patients were treated with minimal invasive surgery（MIS） Gamma nail internal fixation. The rehabilitation group patients received comprehensive rehabilitation training before and after surgery, while the control group patients did not. The postoperative comparative study was conducted. All the patients were followed up routinely. Results All the patients were followed-up for 5 to 36 months （average 21 mouths） , it was revealed that all cases achieved bone union. The healing time was （ 3 ± 0. 5 ） months in rehabilitation group, while in control group it was （ 3.2 ± 0. 4） months, there was no significant different between two groups （ t = 0. 435, P 〉 0. 05 ）. The complication in the rehabilitation group was 13.3% , while in control group it was 30% , there was significant different between two groups （ X^2 = 8. 755, P 〈 0. 01 ）. Conclusions The therapeutic effects of early rehabilitation training for intertrochanteric femoral fractures after MIS Gamma nail fixation are stable, favorable to the patients＇ functional recovery and can improve their quality of life.