目的:探讨人工全髋关节置换术(total hip arthroplasty,THA)后早期下床活动联合穴位贴敷对术后并发症以及髋关节功能的影响。方法:选取2018年6月—2020年6月于我市中医院骨科行THA的患者180例,随机分为对照组(n=60)、观察组(n=60)和锻炼...目的:探讨人工全髋关节置换术(total hip arthroplasty,THA)后早期下床活动联合穴位贴敷对术后并发症以及髋关节功能的影响。方法:选取2018年6月—2020年6月于我市中医院骨科行THA的患者180例,随机分为对照组(n=60)、观察组(n=60)和锻炼组(n=60)。对照组进行常规康复培训,术后1周进行下床锻炼。锻炼组术后3 d进行早期下床活动。观察组在进行早期下床活动的基础上联合应用穴位敷贴进行止痛。比较各组术后并发症与功能恢复情况以及术后视觉模拟疼痛度评分法(VAS)评分。结果:观察组和锻炼组术后28 d内发生下肢深静脉血栓、便秘和假体脱位的概率均低于对照组(P均<0.05)。观察组和锻炼组术后14 d及28 d Harris人工髋关节功能评分中功能性活动、活动度、总分均高于对照组(P均<0.05)。观察组术后14 d Harris人工髋关节功能评分中功能性活动高于锻炼组(P<0.05)。观察组术后5 d及14 d VAS疼痛评分低于对照组和锻炼组(P均<0.05)。结论:早期下床活动联合穴位敷贴能够降低THA术后并发症发生率,改善关节功能,相对单纯早期下床活动能有效改善术后疼痛以及部分功能性活动情况。展开更多
目的研究发育性髋关节脱位(developmental dysplasia of the hip,DDH)切开复位术后髋关节功能不满意的风险因素。方法回顾性分析2008年1月至2015年12月我院收治的采用切开复位治疗且符合纳入标准的63例(76髋) DDH患者临床资料,平均手术...目的研究发育性髋关节脱位(developmental dysplasia of the hip,DDH)切开复位术后髋关节功能不满意的风险因素。方法回顾性分析2008年1月至2015年12月我院收治的采用切开复位治疗且符合纳入标准的63例(76髋) DDH患者临床资料,平均手术年龄(48.8±26.3)个月。按手术方式分为单纯切开复位组、骨盆Salter/Pemberton截骨组以及骨盆三联截骨组。通过X线片评估患髋术前的骨性髋臼指数(acetabular index,AI)、Tnnis分级、术后AI、中心边缘角(center edge angle,CEA)、股骨头缺血性坏死(avascular necrosis of the femoral epiphysis,AVN)和Severin影像学评级。根据患髋的功能评估结果确定髋关节是否存在关节功能不满意,并分析年龄、性别、侧别、术前AI、Tonnis分级、治疗方式(骨盆截骨方式和股骨截骨)、AVN与DDH术后髋关节功能不满意之间的关系。结果末次随访时,22髋(28.9%)出现关节功能不满意。关节功能不满意组的年龄[(53.9±23.0)]个月显著大于功能满意组[(42.4±23.9)]个月,差异有统计学意义(P=0.036)。单纯切开复位组的关节功能不满意发生率(0%)显著低于骨盆Salter/Pemberton截骨组(34.8%)和骨盆三联截骨组(35.3%),差异有统计学意义(P=0.039)。有股骨截骨的患者髋关节功能不满意发生率(38.5%)显著高于无股骨截骨者(8.3%),差异有统计学意义(P=0.013)。18髋(23.7%)出现AVN,有AVN的患者关节功能不满意发生率(64.7%)显著高于无AVN组(19.3%),差异有统计学意义(P=0.001)。术前AI、性别、侧别、Tonnis脱位程度分级与关节功能不满意的发生率无关。结论骨盆截骨、股骨截骨、AVN是导致DDH切开复位术后髋关节功能不满意的风险因素。展开更多
Objective： To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods： 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases...Objective： To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods： 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases in the treatment were treated with combined tuina and rehabilitation, while cases in the control group were treated with rehabilitation alone. All treatment retained for two weeks. The results were observed 7 d, 2 weeks and 6 weeks following the total hip replacement using Harris scale and Hamilton Anxiety Rating Scale （HAMA）. Results： For Harris scale, there were significant intra-group differences in different time frames （P〈0.05）; there were no statistical differences between the two groups 1 d, 7 d and 6 weeks following the total hip replacement （P〉0.05）; and there were statistical differences between the two groups 2 weeks following the total hip replacement. For HAMA scale, there were significant intra-group differences in different time frames （P〈0.05）; there were no significant differences between the two groups 1 d following the total hip replacement; and there were substantial differences between the two groups 7 d, 2 weeks and 6 weeks following the total hip replacement. Conclusion： In a given unit time, combined tuina and rehabilitation is superior to rehabilitation alone in improving the patients＇ post-operative pain, articular range of motion and anxiety.展开更多
文摘目的:探讨人工全髋关节置换术(total hip arthroplasty,THA)后早期下床活动联合穴位贴敷对术后并发症以及髋关节功能的影响。方法:选取2018年6月—2020年6月于我市中医院骨科行THA的患者180例,随机分为对照组(n=60)、观察组(n=60)和锻炼组(n=60)。对照组进行常规康复培训,术后1周进行下床锻炼。锻炼组术后3 d进行早期下床活动。观察组在进行早期下床活动的基础上联合应用穴位敷贴进行止痛。比较各组术后并发症与功能恢复情况以及术后视觉模拟疼痛度评分法(VAS)评分。结果:观察组和锻炼组术后28 d内发生下肢深静脉血栓、便秘和假体脱位的概率均低于对照组(P均<0.05)。观察组和锻炼组术后14 d及28 d Harris人工髋关节功能评分中功能性活动、活动度、总分均高于对照组(P均<0.05)。观察组术后14 d Harris人工髋关节功能评分中功能性活动高于锻炼组(P<0.05)。观察组术后5 d及14 d VAS疼痛评分低于对照组和锻炼组(P均<0.05)。结论:早期下床活动联合穴位敷贴能够降低THA术后并发症发生率,改善关节功能,相对单纯早期下床活动能有效改善术后疼痛以及部分功能性活动情况。
文摘目的研究发育性髋关节脱位(developmental dysplasia of the hip,DDH)切开复位术后髋关节功能不满意的风险因素。方法回顾性分析2008年1月至2015年12月我院收治的采用切开复位治疗且符合纳入标准的63例(76髋) DDH患者临床资料,平均手术年龄(48.8±26.3)个月。按手术方式分为单纯切开复位组、骨盆Salter/Pemberton截骨组以及骨盆三联截骨组。通过X线片评估患髋术前的骨性髋臼指数(acetabular index,AI)、Tnnis分级、术后AI、中心边缘角(center edge angle,CEA)、股骨头缺血性坏死(avascular necrosis of the femoral epiphysis,AVN)和Severin影像学评级。根据患髋的功能评估结果确定髋关节是否存在关节功能不满意,并分析年龄、性别、侧别、术前AI、Tonnis分级、治疗方式(骨盆截骨方式和股骨截骨)、AVN与DDH术后髋关节功能不满意之间的关系。结果末次随访时,22髋(28.9%)出现关节功能不满意。关节功能不满意组的年龄[(53.9±23.0)]个月显著大于功能满意组[(42.4±23.9)]个月,差异有统计学意义(P=0.036)。单纯切开复位组的关节功能不满意发生率(0%)显著低于骨盆Salter/Pemberton截骨组(34.8%)和骨盆三联截骨组(35.3%),差异有统计学意义(P=0.039)。有股骨截骨的患者髋关节功能不满意发生率(38.5%)显著高于无股骨截骨者(8.3%),差异有统计学意义(P=0.013)。18髋(23.7%)出现AVN,有AVN的患者关节功能不满意发生率(64.7%)显著高于无AVN组(19.3%),差异有统计学意义(P=0.001)。术前AI、性别、侧别、Tonnis脱位程度分级与关节功能不满意的发生率无关。结论骨盆截骨、股骨截骨、AVN是导致DDH切开复位术后髋关节功能不满意的风险因素。
文摘Objective： To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods： 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases in the treatment were treated with combined tuina and rehabilitation, while cases in the control group were treated with rehabilitation alone. All treatment retained for two weeks. The results were observed 7 d, 2 weeks and 6 weeks following the total hip replacement using Harris scale and Hamilton Anxiety Rating Scale （HAMA）. Results： For Harris scale, there were significant intra-group differences in different time frames （P〈0.05）; there were no statistical differences between the two groups 1 d, 7 d and 6 weeks following the total hip replacement （P〉0.05）; and there were statistical differences between the two groups 2 weeks following the total hip replacement. For HAMA scale, there were significant intra-group differences in different time frames （P〈0.05）; there were no significant differences between the two groups 1 d following the total hip replacement; and there were substantial differences between the two groups 7 d, 2 weeks and 6 weeks following the total hip replacement. Conclusion： In a given unit time, combined tuina and rehabilitation is superior to rehabilitation alone in improving the patients＇ post-operative pain, articular range of motion and anxiety.
