人工全髋关节置换术前康复干预对术后早期关节功能恢复的影响

EFFECT OF PREOPERATIVE REHABILITATION ON EARLY FUNCTION OF JOINTS AFTER TOTAL HIP ARTHROPLASTY

目的通过与术前未接受康复干预患者比较,探讨人工全髋关节置换术前康复干预对术后早期关节功能恢复的影响。方法 2010年3月-2011年11月,共98例髋关节疾病患者符合选择标准纳入研究。根据术前有无进行康复干预分为两组,每组各49例;试验组术前接受2周康复锻炼,对照组不作处理。两组患者性别、年龄、病程、病因及术前疼痛视觉模拟评分(VAS)、Harris评分比较,差异均无统计学意义(P>0.05),具有可比性。结果两组术后各时间点VAS评分比较,差异均无统计学意义(P>0.05);Harris评分比较差异均有统计学意义(P<0.05)。术后3 d患者康复锻炼依从性评定,试验组完全依从36例、部分依从13例,对照组完全依从27例、部分依从14例、不依从8例,两组比较差异有统计学意义(Z=2.286,P=0.002)。试验组患者均于术后7 d内初次下地;对照组47例7 d内初次下地,2例7 d后下地;两组患者术后初次下地时间比较,差异亦有统计学意义(Z=3.840,P=0.000)。结论术前康复干预能提高人工全髋关节置换患者术后对康复锻炼的依从性,缩短卧床时间,改善早期髋关节功能。

Objective To investigate the effect of preoperative rehabilitation on early function of joints after total hip arthroplasty by comparing with non-preoperative rehabilitation.Methods Between March 2010 and November 2011,98 patients with hip disease were recruited in study.Of 98 patients,49 received preoperative rehabilitation for 2 weeks in trial group,and 49 did not receive preoperative rehabilitation in control group.There was no significant difference in gender,age,disease duration,disease cause,preoperative visual analogue scale（VAS） score,and preoperative Harris score between 2 groups（P 0.05）.Results There was no significant difference in VAS score at each time point after operation between 2 groups（P 0.05）,but significant differences were found in Harris score（P 0.05）.At 3 days after operation,compliance evaluation results showed that 36 cases were of full compliance,and 13 cases were of partial compliance in trial group;27 cases were of full compliance,14 cases were of partial compliance,and 8 cases were of non-compliance in control group;there was significant difference between 2 groups（Z=2.286,P=0.002）.The ambulation time was within 7 days in trial group,and was within 7 days in 47 cases and more than 7 days in 2 cases in control group;there was significant difference between 2 groups（Z=3.840,P=0.000）.Conclusion Preoperative rehabilitation plays an important role in compliance,decreased bed rest time,and hip function improvement in patients after total hip arthroplasty.