目的:探讨电针刺激联合指压阳明经对全髋关节置换术后下肢功能恢复及生活质量的影响。方法:选取90例全髋关节置换术患者为研究对象,按照随机数字表法分为研究组与对照组,各45例,对照组采用指压阳明经治疗,研究组在对照组基础上联合电针...目的:探讨电针刺激联合指压阳明经对全髋关节置换术后下肢功能恢复及生活质量的影响。方法:选取90例全髋关节置换术患者为研究对象,按照随机数字表法分为研究组与对照组,各45例,对照组采用指压阳明经治疗,研究组在对照组基础上联合电针刺激治疗。比较治疗前、治疗后4周,两组下肢功能[Harris髋关节功能评分量表(HHS)]与疼痛程度[视觉模拟评分(VAS)]、生活质量[生活质量简表(SF-36)]评分、血液流变学(血浆黏度、红细胞聚集指数、全血高切黏度、全血低切黏度)水平变化;比较两组步态情况[10 m最快步行速度(10 m MWS)、跨步长、步频]评估变化;比较术后1个月内,两组术后并发症(下肢深静脉血栓、肺部感染、下肢肿胀)发生情况。结果:治疗后4周,研究组HHS、SF-36各项评分均较治疗前显著升高(P<0.05),且均明显高于对照组(P<0.05);治疗后4周,两组VAS评分均较治疗前显著降低(P<0.05),且研究组均明显低于对照组(P<0.05);治疗后4周,研究组10 m MWS、跨步长、步频均较治疗前显著增加(P<0.05),且均明显大于对照组(P<0.05);治疗后4周,研究组血浆黏度、红细胞聚集指数、全血高切黏度、全血低切黏度水平均较治疗前显著降低(P<0.05),且均明显低于对照组(P<0.05);术后1个月内,研究组下肢深静脉血栓、肺部感染、下肢肿胀发生率均明显低于对照组(P<0.05)。结论:电针刺激联合指压阳明经应用于全髋关节置换术患者,可有效改善患者下肢功能、生活质量状态,降低其血液流变学指标水平,降低术后并发症发生率。展开更多
This article analyzes the application of Omaha system in perioperative continuation nursing and discharge follow-up of patients undergoing total hip arthroplasty in China, and combine the Omaha system with mobile medi...This article analyzes the application of Omaha system in perioperative continuation nursing and discharge follow-up of patients undergoing total hip arthroplasty in China, and combine the Omaha system with mobile medical to design a mobile management platform APP suitable for patients with total hip arthroplasty, and strengthen professional training for nurses, with the cooperation of multi-disciplinary teams, will be widely applied and promoted in clinical, in order to better manage and improve the nursing outcomes of patients with total hip arthroplasty and enhance the quality of life of patients.展开更多
Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of dail...Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of daily living in total hip arthroplasty （THA）. Methods： A three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion ≥ 120°, internal rotation ≥ 45° at 90° flexion, extension ≥ 30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck （CCD）-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios （GR=2, 2.17, 2.37, 2.61 and 2.92） and femoral anteversions （FA=0°, 10°, 20° and 30°）. Results： Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR〉2.37 could further increase the size of safe-zones. There was a complexinterplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion （OA） and femoral antetorsion （FA） could be estimated by the formula： OA=-0.80×FA＋47.06, and the minimum allowable operative acetabular inclination （OImin） would be more than 2 10.5 ×GR^-2255. Conclusions： Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination （OI）, surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients＇ individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.展开更多
文摘目的:探讨电针刺激联合指压阳明经对全髋关节置换术后下肢功能恢复及生活质量的影响。方法:选取90例全髋关节置换术患者为研究对象,按照随机数字表法分为研究组与对照组,各45例,对照组采用指压阳明经治疗,研究组在对照组基础上联合电针刺激治疗。比较治疗前、治疗后4周,两组下肢功能[Harris髋关节功能评分量表(HHS)]与疼痛程度[视觉模拟评分(VAS)]、生活质量[生活质量简表(SF-36)]评分、血液流变学(血浆黏度、红细胞聚集指数、全血高切黏度、全血低切黏度)水平变化;比较两组步态情况[10 m最快步行速度(10 m MWS)、跨步长、步频]评估变化;比较术后1个月内,两组术后并发症(下肢深静脉血栓、肺部感染、下肢肿胀)发生情况。结果:治疗后4周,研究组HHS、SF-36各项评分均较治疗前显著升高(P<0.05),且均明显高于对照组(P<0.05);治疗后4周,两组VAS评分均较治疗前显著降低(P<0.05),且研究组均明显低于对照组(P<0.05);治疗后4周,研究组10 m MWS、跨步长、步频均较治疗前显著增加(P<0.05),且均明显大于对照组(P<0.05);治疗后4周,研究组血浆黏度、红细胞聚集指数、全血高切黏度、全血低切黏度水平均较治疗前显著降低(P<0.05),且均明显低于对照组(P<0.05);术后1个月内,研究组下肢深静脉血栓、肺部感染、下肢肿胀发生率均明显低于对照组(P<0.05)。结论:电针刺激联合指压阳明经应用于全髋关节置换术患者,可有效改善患者下肢功能、生活质量状态,降低其血液流变学指标水平,降低术后并发症发生率。
文摘This article analyzes the application of Omaha system in perioperative continuation nursing and discharge follow-up of patients undergoing total hip arthroplasty in China, and combine the Omaha system with mobile medical to design a mobile management platform APP suitable for patients with total hip arthroplasty, and strengthen professional training for nurses, with the cooperation of multi-disciplinary teams, will be widely applied and promoted in clinical, in order to better manage and improve the nursing outcomes of patients with total hip arthroplasty and enhance the quality of life of patients.
基金This work was supported by grants from Science Foundation from Sci-Tech Committee of Zhejiang Province （No. 2009C33144）, Science Foundation from Sci-Tech Committee of Wenzhou City （No. Y20070043） and Science Foundation from Sci-Tech Committee of Rui＇an City （No. 20082088）.
文摘Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of daily living in total hip arthroplasty （THA）. Methods： A three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion ≥ 120°, internal rotation ≥ 45° at 90° flexion, extension ≥ 30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck （CCD）-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios （GR=2, 2.17, 2.37, 2.61 and 2.92） and femoral anteversions （FA=0°, 10°, 20° and 30°）. Results： Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR〉2.37 could further increase the size of safe-zones. There was a complexinterplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion （OA） and femoral antetorsion （FA） could be estimated by the formula： OA=-0.80×FA＋47.06, and the minimum allowable operative acetabular inclination （OImin） would be more than 2 10.5 ×GR^-2255. Conclusions： Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination （OI）, surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients＇ individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.
