髌骨骨折术后不同体位护理联合早期康复训练对膝关节功能恢复的影响

Effect of different body position care combined with early rehabilitation training on the functional recovery of knee joint after surgery for fracture of patella

目的：探讨髌骨骨折术后不同体位护理联合早期康复训练对膝关节功能恢复的影响。方法：将47例髌骨骨折患者随机分为实验组24例和对照组23例,实验组内固定术后局部弹力绷带包扎,膝后垫软枕,予屈曲膝关节90°-120°体位放置;常规组内固定术后常规抬高患肢15°-20°,膝后垫软枕,膝关节屈曲5°-10°体位。两组患者术后均实施冷敷,第2天由主管医生、护士和康复师对其进行康复指导,分别于术后第3天、第14天、第30天比较两组患者不同体位护理效果。结果：实验组患肢肿胀、疼痛程度明显轻于对照组,功能锻炼主动配合、膝关节功能恢复情况明显优于对照组,患者平均住院天数明显短于对照组（P〈0.05）;实验组早期体位舒适度较对照组差（P〈0.05）。结论：髌骨骨折患者术后正确的体位、早期及时正确的功能锻炼是膝关节功能康复的关键。

Objective：To investigate the effect of different body position care combined with early rehabilitation training on the functional recovery of knee joint after fracture of patella. Methods ：47 patients with patellar fracture were randomly divided into the experimental group （ n = 24） and the control group （ n = 23 ）. The local bandage was adopted with elastic bandages and soft pillow was used to cushion the knee flexion （90° - 120°） after internal fixation in the experimental group;the affected limb was lifted about 15° - 20°） and soft pil- low was put under the knee in the position of knee flexion （ 5° - 10° ） after internal fixation in the control group. The patients in both groups were treated with cold compress after operation and they were given rehabilitation guidance by the doctor and nurse in charge and physical therapist on the second day, the effect of different body position care was compared respectively on the 3rd, 14th and 30th day after operation. Results：The severity of swelling and pain of the patients was significantly milder in the experimental group than the control group ; the functional exercise initiative and the recovery of knee joint function was evidently better and the average days of hospitalization were significantly shorter in the experimental group than the control group （ P 〈 0.05 ） ;the degree of postural comfort at the early stage was inferior in the experimental group to the control group （ P 〈 0.05 ）. Conclusion ：The correct body position and the early and timely function- al exercise is the key to the rehabilitation of knee joint function of the patients after surgery for fracture of patella.