早期康复护理对骨盆恶性肿瘤患者组合式半骨盆置换术后患肢功能的影响

Effect of early rehabilitation nursing on limb function in patients with pelvic malignant tumors after combined hemipelvic replacement

目的探讨早期康复护理对骨盆恶性肿瘤患者行组合式半骨盆置换术后患肢功能的影响。方法选取2016年8月至2019年3月间陕西省康复医院收治的68例骨盆恶性肿瘤患者为研究对象,患者均行半骨盆切除、组合式半骨盆假体和全髋关节置换术。根据护理方法不同进行分组,其中,行常规护理的34例患者纳入常规组,在常规护理的基础上给予早期康复护理的34例患者纳入观察组。观察两组患者治疗前后疼痛程度、髋关节功能恢复及患肢最终功能情况,比较两组患者术后并发症发生率和患者满意度。结果两组患者术前疼痛、髋关节功能及患肢功能评分比较,差异无统计学意义(P> 0. 05)。研究组患者术后3个月、6个月的疼痛评分显著低于常规组患者,且髋关节功能和患肢功能评分均高于常规组患者,差异均有统计学意义(均P <0. 05),术后1年,两组患者疼痛、髋关节功能及患肢功能评分比较。差异无统计学意义(P> 0. 05)。研究组患者术后并发症发生率为11. 8%,低于常规组患者的35. 3%,差异有统计学意义(P <0. 05)。研究组患者满意率为94. 1%,高于常规组患者的70. 6%,差异有统计学意义(P <0. 05)。结论早期康复护理能够显著加速行组合式半骨盆置换术的骨盆恶性肿瘤患者髋关节功能和患肢最终功能的恢复,降低患者的疼痛和并发症发生率,提升患者满意率。

Objective To observe the effect of early rehabilitation nursing on the function of the affected limb after combined hemipelvic replacement in patients with pelvic malignant tumors. Methods A total of 68 patients with pelvic malignant tumors treated at Shaanxi Provincial Rehabilitation Hospital from August 2016 to March 2019 were selected. These patients underwent hemipelvic resection,combined hemipelvic prosthesis and total hip replacement. Based on the nursing care they received,they were divided into two groups. Thirty-four patients who received early rehabilitation nursing apart from conventional nursing were included in an observation group and 34 patients who received conventional nursing were included in a control group. Changes in pain before and after the treatment,the recovery of hip function and the score of affected limb were observed. The incidence of postoperative complications and patient satisfaction were compared between the two groups. Results There was no significant difference in pain,hip function and the score of affected limb between the two groups before the treatment( P > 0. 05). At 3 months and6 months,score of pain was lower in the observation group than in the control group( P < 0. 05). Moreover,hip function and the score of affected limb were higher in the observation group than in the control group( P < 0. 05). At 1 year,there was no significant difference in the above three indicators between the two groups( P > 0. 05). The incidence of postoperative complications was 11. 8 % in the observation group which was significantly lower than 35. 3 % of the control group( P < 0. 05). Patient satisfaction rate was 94. 1 % in the observation group,which was significantly higher than 70. 6 % of the control group( P < 0. 05). Conclusion Early rehabilitation nursing can significantly accelerate the recovery of hip function and the function of affected limb reduce the incidence of pain and complications,and increase patient satisfaction rate in patients with pelvic malignant tumors undergoing combined hemipelvic replacement.