康复早期介入对髋部骨折老年患者肺部感染的影响分析

Effect of early intervention on pulmonary infections in elderly patients with hip fracture

目的探讨康复早期介入对老年髋部骨折肺部感染的影响。方法选择2012年6月-2016年6月就诊的髋部骨折患者864例,随机分为研究组和对照组,各432例,两组均给予基础治疗,对照组给予常规骨科康复训练,研究组采用康复早期介入,观察患者术后2周并发症发生情况,对肺部感染患者的痰、尿、血等进行细菌培养和鉴定,对术后2周、1个月、3个月、6个月患者的髋关节功能及活动能力进行评定,对两组患者的骨愈合程度进行判定。结果研究组肺部感染12例,感染率2.78%,显著低于对照组37例感染率8.56%(P<0.05),研究组患者治疗后2周、1个月、3个月、6个月髋关节功能评分分别为(54.23±6.54)分、(67.33±5.41)分、(81.04±5.65)分、(92.21±5.48)分,均高于对照组(40.84±5.44)分、(45.83±4.95)分、(60.40±6.40)分、(73.83±6.95)分,差异有统计学意义(P<0.05);共检测出104株病原菌,其中革兰阴性菌59株占56.73%,革兰阳性菌39株占37.50%,真菌6株占5.77%;治疗前,两组患者生活活动能力比较差异无统计学意义,干预后两组患者生活活动能力评分均显著较治疗前升高,差异有统计学意义(P<0.05),研究组患者治疗有效率为97.69%显著高于对照77.31%(P<0.05)。结论康复早期介入能够显著降低老年髋部骨折患者肺部感染发生率,提高髋关节功能和生活活动能力,提高治疗有效率。

OBJECTIVE To explore the effect of early rehabilitation intervention on pulmonary infections in elderly patients with hip fracture.METHODS A total of 864 cases of patients with hip fracture from Jun.2012 to Jun.2016 were selected,and randomly divided into study group and control group,with 432 cases in each group.Two groups of patients were given basic treatment,control group was given routine rehabilitation training of department of orthopedics,and the study group used early rehabilitation intervention.The complications of 2weeks after operation were observed.The sputum,urine and blood of patients with pulmonary infection were used for bacterial culture and identification,the hip function and activity were evaluated at 2weeks,1 month,3 months and 6months after operation,and the degree of bone healing in the two groups was determined.RESULTS There were12 cases of pulmonary infection in study group,with the infection rate of 2.78%,which was significantly lower than 37cases（8.56%）in control group（P〈0.05）.The hip function scores of study group were（54.23±6.54）,（67.33±5.41）,（81.04±5.65）and（92.21±5.48）at 2weeks,1month,3months and 6months after operation,which were higher than（40.84±5.44）,（45.83±4.95）,（60.40±6.40）and（73.83±6.95）of control group,the differences were statistically significant（P〈0.05）.Totally 104 strains of pathogenic bacteria were detected,including 59 strains of gram-negative bacteria,39 strains of gram-positive bacteria and 6strains of fungi,accounting for 56.73%,37.50% and 5.77% Before treatment,the two groups had no statistically significant difference in life ability.After intervention,ADL scores of the two goups were significantly higher than those before intervention（P〈0.05）.The effective rate of study group was 97.69%,which was significantly higher than77.31% of control group（P〈0.05）.CONCLUSION Early intervention can significantly reduce the incidence of pulmonary infections in elderly patients with hip fracture,improve hip function and activities of daily living,and improve the efficiency of treatment.