吸气肌训练在老年股骨颈骨折髋关节置换术患者围手术期功能康复中的应用

Application of inspiratory muscle training in perioperative functional rehabilitation in elderly patients with femoral neck fracture undergoing hip replacement

目的观察吸气肌训练对老年股骨颈骨折髋关节置换术患者围手术期呼吸功能、肺部感染发生率及髋关节功能的影响。方法行人工髋关节置换术的老年股骨颈骨折患者80例随机均分为常规康复+吸气肌训练组(A组)和常规康复训练组(B组)。记录手术前后患者吸气肌的最大吸气压,观察术后肺部感染发生率,采用髋关节Harris量表评估髋关节功能。结果 A组术后3、6、9、14d吸气肌的最大吸气压高于B组(P<0.05);A组肺部感染发生率低于B组(5.0%vs.22.5%)(P<0.05);A组术后髋关节功能优于B组[(82.87±4.43)分vs.(74.97±5.22)分](P<0.05)。结论吸气肌训练能有效改善老年股骨颈骨折髋关节置换术患者围手术期呼吸功能,减少肺部感染发生,促进髋部骨折肢体功能恢复。

Objective To observe the effect of inspiratory muscle training on perioperative respiratory function,incidence of pulmonary infection and hip function in elderly patients with femoral neck fracture undergoing hip replacement.Methods A total of 80 elderly patients with femoral neck fracture received hip replacement was equally randomized into two groups.The patients in group A received conventional rehabilitation combined with inspiratory muscle training.The patients in group B were given conventional rehabilitation only.The maximum inspiratory pressure was recorded before and after operation.The incidence of pulmonary infection was observed and hip function was assessed by Harris hip score.Results The maximum inspiratory pressures on the 3 rd,6 th,9 th and 14 th day after operation in group A were higher than those in group B（P〈0.05）.Compared with group B,the incidence of pulmonary infection was lower（5.0% vs.22.5%）,while Harris hip score was higher in group A[（82.87±4.43）points vs.（74.97±5.22）points]（P〈0.05）.Conclusion Inspiratory muscle training can effectively improve perioperative respiratory function,reduce the occurrence of pulmonary infection and promote the functional recovery of hip joint in elderly patients with femoral neck fracture undergoing hip replacement.