规范化步行管理对髋关节置换术后患者加速康复效果的影响

The standardized mobilization training accelerates rehabilitation of patients after total hip arthro⁃plasty

目的制定更规范的髋关节置换术后步行管理方案,观察其对患者术后康复效果的影响。方法选取广州市番禺区中心医院关节外科2019年行髋关节置换术的患者共68例,其中32例接受常规康复(常规康复组)治疗;36例在常规护理基础上实施早期规范化步行管理(规范化管理组)。比较两组术后疼痛VAS评分、Harris评分,出院时Barthel指数,单次行走距离,术后3个月生活质量的差异。结果术后2周,接受早期规范化步行管理的患者的Harris评分和单次行走距离分别为81.5±6.2分和126.5±24.3 m,常规康复组患者分为78.1±7.5分和102.8±29.26 m,两组间差异有统计学意义(P<0.05);出院时Barthel指数评定,早期规范化步行管理患者为90.04±6.16分,常规康复组为85.31±8.02分,两组比较有统计学意义(P<0.05);术后3个月,反映生活质量的EQ-5D评分在两组间比较的差异没有统计学意义(P>0.05)。结论规范化步行管理有助于髋关节置换术后患者的加速康复。

Objective To develop a standardized mobilization training management for patients after hip replacement,and observe its impact on postoperative rehabilitation of patients.Methods Sixty⁃eight patients who underwent total hip arthroplasty in 2019 were assigned to standardized mobilization training management group(observation group,n=36)and control group(common rehabilitation group,n=32).The differences in VAS score,Harris score,Barthel index at discharge,single walking dis⁃tance,and quality of life 3 months after operation were compared between the two groups during follow⁃up.Results Two weeks after the operation,Harris score was 81.5±6.2 points in the observation group and 78.1±7.5 points in the control group(P<0.05).The single walking distance was 126.5±24.3 m in the observation group and 102.8±29.26 m in the control group(P<0.05).Barthel index assessment at dis⁃charge in the observation group and the control group were 90.04±6.16 and 85.31±8.02(P<0.05).The EuroQoL Five⁃dimension Questionnaire(EQ⁃5D)in the experimental group was 62.96 points and 59.90 points in the control group(P<0.05).There was no difference in postoperative VAS score(P>0.05).Conclusion The model of standardized mobilization training management helps accelerate the recovery of patients after hip replacement.