对接受全髋关节置换术的髋关节强直畸形患者进行快速康复治疗的效果研究

To study the effect of rapid rehabilitation on patients with total hip arthroplasty

目的 :评价对接受全髋关节置换术的髋关节强直畸形患者进行快速康复治疗的效果。方法 :对2010年1月1日至2016年12月31日在四川大学华西医院骨科接受全髋关节置换术的85例髋关节强直畸形患者的临床资料进行回顾性分析。根据围手术期处理方式的差异将其分为A组(21例)和B组(64例)。对A组患者进行常规的围手术期处理,对B组患者进行快速康复治疗。然后比较两组患者围手术期的失血量、引流管的留置率、输血率、各项术后并发症的发生率、出院时髋关节屈曲及外展的活动度、Harris评分的改善率、术后住院的时间、治疗的费用和术后30d内再入院率。结果:1)B组患者围手术期的失血量少于A组患者,其输血率、引流管的留置率均低于A组患者,差异有统计学意义(P <0.05)。2)B组患者术后住院的时间短于A组患者,其切口相关并发症的发生率低于A组患者,差异有统计学意义(P <0.05)。3)B组患者出院时髋关节的屈伸活动度大于A组患者,其Harris评分的改善率及治疗的费用均高于A组患者,差异有统计学意义(P <0.05)。4)两组患者出院时髋关节的外展活动度、血栓的发生率、髋关节假体脱位的发生率、髋关节假体周围感染的发生率、术后30 d内再入院率相比,差异无统计学意义(P>0.05)。结论:对接受全髋关节置换术的髋关节强直畸形患者进行快速康复治疗能够促进其髋关节功能的恢复,缩短其住院的时间,降低其术后并发症的发生率。

Objective： To evaluate the effect of rapid rehabilitation for patients with total hip arthroplasty. Methods： retrospective analysis was performed on the clinical data of 85 patients with total hip arthroplasty who received total hip arthroplasty in the department of orthopedics, west China hospital, sichuan university on 31 December 2016. It was divided into group A（21 cases） and group B（64 cases） according to the differences in perioperative treatment. Patients in group A were treated routinely in perioperative period, and patients in group B were treated with rapid rehabilitation. Then, perioperative blood loss, retention rate of drainage tube, blood transfusion rate, incidence of postoperative complications, activity of hip flexion and abduction at discharge, improvement rate of Harris score, time of postoperative hospitalization, cost of treatment and re-admission rate within 30 days after operation were compared between the two groups. Results： 1） the perioperative blood loss of group B was less than that of group A, and the blood transfusion rate and the retention rate of the drainage tube were lower than those of group A, with statistically significant differences（P 0.05）. 2） the length of postoperative hospitalization in group B was shorter than that in group A, and the incidence of incision-related complications was lower than that in group A, with statistically significant differences（P 0.05）. 3） when discharged from the hospital, the hip flexion and extension activity of group B was greater than that of group A, and the improvement rate of Harris score and treatment cost were higher than those of group A, with statistically significant difference（P 0.05）. 4） there was no statistically significant difference（P 0.05） between the two groups in the incidence of hip abduction, thrombosis, hip prosthesis dislocation, infection around the hip prosthesis, and readmission rate within 30 days after the operation. Conclusion： rapid rehabilitation for patients with total hip arthroplasty can promote the recovery of hip function, shorten the length of hospitalization and reduce the incidence of postoperative complications.