髋关节置换术后患者应用全程护理联合普拉提训练

Application of full course nursing combined with Pilates exercise in patients of total hip replacement

目的探讨全程护理联合普拉提康复训练(PME)对改善髋关节置换术(THR)后患者康复效果的影响。方法选取2018年4月至2019年4月佛山市中医院收治的130例THR术后患者,采用随机数字表分为对照组(64例)和观察组(66例),其中对照组采用常规的随访护理及康复锻炼,观察组采用全程护理联合PME康复训练;收集两组患者的Harris髋关节功能得分、独立功能得分(FIM)、锻炼依从性及并发症发生率,并分别采用t检验、重复测量方差分析、卡方检验及秩和检验进行统计学处理。结果两组在干预前的Harris髋关节功能得分和FIM得分差异无统计学意义(P>0.05),干预1、3、6个月后观察组的得分明显高于对照组;观察组的锻炼依从性明显高于对照组(Z=4.302,P<0.01),两组的并发症发生率差异无统计学意义(P>0.05);重复测量方差分析显示,两组患者的Harris髋关节功能得分和FIM得分在时间效应、组别效应及交互影响均有统计学意义(P<0.05)。结论全程护理联合PME康复训练能有效提升患者的锻炼依从性,促进髋关节功能恢复,值得在临床中推广应用。

Objective To probe into and discuss the effect of full course nursing combined with Pilates method of exercise(PME)on improving the rehabilitation efficacy of post-operative patients with total hip replacement(THR).Methods A total of 130 THR post-operative patients in Foshan Hospital of traditional Chinese from April 2018 to April 2019 were randomly divided into the control group(64 cases)and the observation group(66 cases).The control group adopted the routine follow-up visit nursing and rehabilitation exercise,while the observation group adopted the full course nursing combined with PME for rehabilitation.The following indexes of the two groups were collected:Harris hip function score,functional independent measures(FIM)independent function score,doctor’s advice compliance and complication occurrence rate.Independent sample t-test,repeated measurement analysis of variance,chi-square test and rank sum test were used for statistical analysis.Results The differences of the two groups in Harris hip function score and FIM independent function score before intervention were not of statistical significance(P>0.05).In the 1st month,3rd month and 6th month after intervention,the scores of the observation group were evidently higher than those of the control group.The compliance of the Observation group was evidently superior to that of the control group(Z=4.302,P<0.01).The difference of the two groups in complication occurrence rate were not of statistical significance(P>0.05).Repeated measurement analysis of variance showed that Harris hip function score and FIM score of the two groups had significant effect on time effect,group effect and interaction(P<0.05).Conclusion Full course nursing combined with PME can improve the compliance of the patients,rehabilitation of hip functions and functions of daily activities efficiently,which is worthy of being promoted in clinics.