基层医院建立骨科-康复科治疗单元模式的临床实践探讨

Clinical study on setting up Orthopedics and Rehabilitation unit model in grass roots hospitals

目的探讨在基层医院建立骨科-康复科治疗单元的可行性及优越性,观察组织化医疗模式的临床效果。方法 2005年10月至2010年12月,将200例胫骨干骨折患者随机分为试验组(100例)和对照组(100例)。试验组按照自行设计的骨科-康复科治疗单元模式进行治疗,对照组按照传统方法治疗,分别于手术前、手术后14d、90d及1年对两组患者关节功能及疗效进行对比分析。结果试验组治疗后膝、踝关节功能按Johner-Wruhs方法评价,优75例,良21例,中2例,差2例,优良率为96%。对照组100例,优57例,良24例,中10例,差9例,优良率为81%,试验组优良率明显高于对照组。结论采用骨科-康复科治疗单元模式能明显改善患者预后,提高患者的生活质量,是适合我国基层医院骨科、康复科发展的治疗模式,具有可行性及优越性。

Objective To explore the feasibility and advantages of setting up Orthopedics- rehabilitation unit model in grass roots hospitals, and observe the clinical curative effects of organized treatment model. Methods Two hundred patients with tibial shaft fractures from October 2005 to December 2010 were randomly divided into the study group （n=100） and the control group （n=100）. The study group was treated with orthopedics-rehabilitation unit model, while the control group were treated with traditional method. Before surgery, 14 days, 90 days and one year af- ter surgery, the joint function and efficacy were analyzed between the two groups. Results After treatment, the func- tion of knee and ankle were evaluated by Johner-Wruhs evaluation system. In the study group, the function were evalu- ated as excellent in 75 cases, good in 21 eases, fair in 2 cases and poor 2 cases, with an excellent and good rate of 96%. In the control group, the results were excellent in 57 cases, good in 24 cases, fair in 10 cases and poor in 9 cases, with an excellent and good rate of 81%. The excellent and good rate was significantly higher in the study group than the control group. Conclusion In grass roots hospitals, the self-designed orthopedics-rehabilitation unit model can significantly ameliorate the prognosis of patients and improve the quality of life of patients, which is the suitable mod- el for the development of orthopedics and rehabilitation in the grass roots hospitals in China.