人工肱骨头置换术后围手术期系统康复的临床研究

A clinical study on early postoperative rehabilitation following humeral head replacement

目的:前瞻性研究人工肱骨头置换术(HHR)患者,术后围手术期康复治疗的疗效。方法:选择2002年3月—2003年2月住院治疗HHR患者20例,术后24小时开始实施系统个性化康复治疗方案。结果:术后12周,患者已经能够完成绝大部分日常生活;GEPI评分:术后6周25.6%±2.6%,术后12周10.2%±3.1%,治疗结束时8.3%±1.6%;术后12周,肩关节被动ROM达到正常范围;术后24周,肩部肌肉肌力达到4级以上,能够完全满足患者日常生活的需要。结论:HHR患者术后实行围手术期、个性化、系统性康复治疗,能够促进骨折愈合、伤肢功能障碍降低到最低程度,从而提高严重创伤患者的生活质量,康复治疗是骨关节损伤治疗过程中必不可少的重要环节。

Objective: To study prospectivelly the effect of postoperative rehabilitation following humeral head replacement (HHR), with tailor rehabilitation procedure.Method:20 patients with HHR who were admitted in our hospital from Mar.2002 to Feb.2003 were obtained.The rehabilitation process started as soon after surgery as the physician would allow, usually began at 24 hour postoperatively.Passive and active-assisted, active ROM exercises,daily strengthening and anti-resistance exercises were performed in different periods. Result:①All patients could perform most of daily living and passive ROM of shoulder were obtained nearly normal at 12 weeks postoperatively.②According the GEPI′s score of shoulder,it was from 23.1±1.5% at 8 weeks postoperatively to 8.3±1.6% at the end of rehabilitation.③All of the patients with HHR returned to work or obtained nearly normal function of the shoulder.Conclusion:Early rehabilitation can facilitate restoration function and range of motion for patients with HHR. The rehabilitation plan must be modified according to the patient′s condition and the state of the tissues observed during surgery. Author′s address Dept. of Physical Medicine and Rehabilitation, Beijing Jishuitan Hospital, Beijing,100035