循坐骨神经穴位针刺联合分阶段康复训练法对老年股骨颈骨折髋关节置换术后患者的疗效

Observation of rehabilitation effect of acupuncture of acupoint along sciatic nerve combined with staged rehabilitation training on senile hip replacement patients with femoral neck fracture

目的:探讨循坐骨神经穴位针刺联合分阶段康复训练法对老年股骨颈骨折(FNF)髋关节置换术后患者的疗效。方法:选取2019年6月—2021年6月来上海市第五康复医院就诊并符合纳入标准的老年FNF患者86例,参照随机数字表法分入观察组与对照组,每组43例。两组均进行常规全髋关节置换术及术后常规干预措施;对照组采取分阶段康复训练法干预;观察组在对照组的基础上行循坐骨神经穴位针刺干预。两组连续观察3个月。比较两组髋关节Harris评分、骨折愈合时间、骨密度、临床疗效及并发症。结果:术后3个月,观察组患者的Harris评分明显高于对照组,而骨折愈合时间显著短于对照组(P<0.01);术后3个月,两组腰椎正位(L2-4)、右跟骨、股骨颈的骨密度明显升高,且观察组明显高于对照组(P<0.01);末次随访当日,观察组的髋关节功能优良率较对照组提升更加显著(90.70%vs 69.77%,P<0.05);观察组患者中下肢深静脉血栓与假体松动发生率显著低于对照组(4.66%vs 23.26%,P<0.05)。结论:于西医常规干预基础上,循坐骨神经穴位针刺联合分阶段康复训练法对老年FNF髋关节置换术后患者的效果更优,有助于髋关节功能改善及骨折愈合,减少并发症。

Objective To investigate the efficacy of rehabilitation effect of acupuncture of acupoint along sciatic nerve combined with staged rehabilitation training on senile hip replacement patients with femoral neck fracture(FNF).Methods Eighty-six elderly FNF patients from Shanghai Fifth Rehabilitation Hospital from June of 2019 to June of 2021 and met the inclusion criteria were selected and divided into observation group and control group according to random number table method with 43 patients in each group.Conventional total hip replacement and postoperative routine intervention were performed in both groups.The control group took staged rehabilitation training.On the basis of the control group,the observation group received acupuncture of acupoint along sciatic nerve.The two groups were observed for 3 months.Harris hip score,fracture healing time,bone mineral density(BMD),clinical efficacy and complications were compared between the two groups.Results 3months after surgery,Harris score of observation group was significantly higher than that of control group,and the fracture healing time was significantly shorter than that of control group(P<0.01).3 months after operation,BMD of lumbar vertebrae(L2-4),right calcaneus and femoral neck significantly increased in both groups,but the observation group was significantly higher than of the control group(P<0.01).On the day of the last follow-up,the excellent and good rate of hip joint function in the observation group improved more significantly than that of the control group(90.70%vs 69.77%,P<0.05).The incidence of lower limb deep vein thrombosis and prosthesis loosening in observation group was significantly lower than that of the control group(4.66%vs 23.26%,P<0.05).Conclusion On the basis of conventional treatment of western medicine,acupuncture of acupoint along sciatic nerve combined with staged rehabilitation training on senile hip replacement patients with FNF has a better effect,which is helpful to improve hip function,reduce the time of fracture healing and complications.