人工全髖關節置換術前康復干預對術后早期關節功能恢復的影響_《中國修復重建外科雜志》

作者：

呂汐妍 ^1,2 , 王躍 ¹ , 譚波 ¹

1四川省人民醫院骨科（成都，610072）;;
2甘肅省中醫院;

關鍵詞：

人工全髖關節置換術術前康復干預關節功能

DOI：

10.7507/1002-1892.20130145

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目的通過與術前未接受康復干預患者比較，探討人工全髖關節置換術前康復干預對術后早期關節功能恢復的影響。方法2010年3月－2011年11月，共98例髖關節疾病患者符合選擇標準納入研究。根據術前有無進行康復干預分為兩組，每組各49例；試驗組術前接受2周康復鍛煉，對照組不作處理。兩組患者性別、年齡、病程、病因及術前疼痛視覺模擬評分（VAS）、Harris評分比較，差異均無統計學意義（P gt; 0.05），具有可比性。結果兩組術后各時間點VAS評分比較，差異均無統計學意義（P gt; 0.05）；Harris評分比較差異均有統計學意義（P lt; 0.05）。術后3 d患者康復鍛煉依從性評定，試驗組完全依從36例、部分依從13例，對照組完全依從27例、部分依從14例、不依從8例，兩組比較差異有統計學意義（Z=2.286，P=0.002）。試驗組患者均于術后7 d內初次下地；對照組47例7 d內初次下地，2例7 d后下地；兩組患者術后初次下地時間比較，差異亦有統計學意義（Z=3.840，P=0.000）。結論術前康復干預能提高人工全髖關節置換患者術后對康復鍛煉的依從性，縮短臥床時間，改善早期髖關節功能。

引用本文： 呂汐妍,王躍,譚波. 人工全髖關節置換術前康復干預對術后早期關節功能恢復的影響. 中國修復重建外科雜志, 2013, 27(6): 653-656. doi: 10.7507/1002-1892.20130145 復制

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2.	Louw A, Diener I, Butler DS, et al. Preoperative education addressing postoperative pain in total joint arthroplasty: Review of content and educational delivery methods. Physiother Theory Pract, 2011, 29(3): 175-194.
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5.	唐麗華, 焦裕霞, 李東白. 術中靜注帕瑞昔布鈉對老年患者髖關節置換術術后疼痛的影響. 臨床軍醫雜志, 2011, 39(3): 576-577.
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8.	Garbuz DS, Xu M, Duncan CP, et al. Delays worsen quality of life outcome of primary total hip arthroplasty. Clin Orthop Relat Res, 2009, (447): 79-84.
9.	Kishida Y, Sugano N, Sakai T, et al. Full weight-bearing after cementless total hip arthroplasty. Int Orthop, 2001, 25(1): 25-28.
10.	Rikli R, Jones J. Development and validation of a functional fitnesstest for community residing older adults. JAPA, 2010, 7(2): 129-161．.
11.	Johansson HR, Bergschmidt P, Skripitz R, et al. Impact of preoperative function on early post operative outcome after total hip arthroplasty. J Orthop Surg (Hong Kong), 2010, 18(1): 6-10.
12.	Moon LB, Backer J. Relationship among self-efficacy, outcome expectancy, and postoperative behaviors in total joint replacement patients. Orthop Nurs, 2000, 19(2): 77-85.
13.	方漢萍, 杜杏利, 郭風勁, 等. 全髖關節置換術后不同時間開始康復訓練的效果研究. 中華護理雜志, 2006, 41(1): 16-19.
14.	Johansson HR, Bergschmidt P, Skripitz R, et al. Impact of preoperative function on early post operative outcome after total hip arthroplasty. J Orthop Surg (Hong Kong), 2010, 18(1): 6-10.
15.	Holtzman J, Saleh K, Kane R. Effect of baseline functional status and pain on outcomes of total hip arthroplasty. J Bone Joint Surg (Am), 2002, 84-A(11): 1942-1948.
16.	Tateuchi H, Tsukagoshi R, Fukumoto Y, et al. Dynamic hip joint stiffness in individuals with total hip arthroplasty: relationships between hip impairments and dynamics of the other joints. Clin Biomech (Bristol, Avon), 2011, 26(6): 598-604.
17.	Bin Nasser A, Beaulé PE, O’Neill M, et al. Incidence of groin pain after metal-on-metal hip resurfacing. Clin Orthop Relat Res, 2010, 468(2): 392-399.
18.	郭艾, 羅先正, 王志義, 等. 人工全髖關節置換術后康復治療和訓練計劃. 中國臨床康復醫學雜志, 1997, 12(5): 210-211.
19.	Britton AR, Murray DW, Bulstrode CJ, et al. Pain levels after total hip replacement: their use as endpoints for survival analysis. J Bone Joint Surg (Br), 1997, 79(1): 93-98.

1. 王亦璁. 骨與關節損傷. 4版. 北京: 人民衛生出版社, 2007: 272．.
2. Louw A, Diener I, Butler DS, et al. Preoperative education addressing postoperative pain in total joint arthroplasty: Review of content and educational delivery methods. Physiother Theory Pract, 2011, 29(3): 175-194.
3. 賴桂蘭. 全髖關節置換術前康復教育對術后康復效果的研究. 醫學信息, 2011, 24(1): 334-336.
4. 施培華, 趙凱. 全髖關節置換及其康復治療. 中國矯形外科雜志, 2010, 5(4): 313-314．.
5. 唐麗華, 焦裕霞, 李東白. 術中靜注帕瑞昔布鈉對老年患者髖關節置換術術后疼痛的影響. 臨床軍醫雜志, 2011, 39(3): 576-577.
6. Resnick D. 骨與關節疾病診斷學. 4版. 天津: 天津科技翻譯出版公司, 2009: 225-226.
7. Röder C, Staub LP, Eggli S, et al. Infuence of preoperative functional status on outcome after total hip arthroplasty. J Bone Joint Surg (Am), 2011, 89(1): 11-17.
8. Garbuz DS, Xu M, Duncan CP, et al. Delays worsen quality of life outcome of primary total hip arthroplasty. Clin Orthop Relat Res, 2009, (447): 79-84.
9. Kishida Y, Sugano N, Sakai T, et al. Full weight-bearing after cementless total hip arthroplasty. Int Orthop, 2001, 25(1): 25-28.
10. Rikli R, Jones J. Development and validation of a functional fitnesstest for community residing older adults. JAPA, 2010, 7(2): 129-161．.
11. Johansson HR, Bergschmidt P, Skripitz R, et al. Impact of preoperative function on early post operative outcome after total hip arthroplasty. J Orthop Surg (Hong Kong), 2010, 18(1): 6-10.
12. Moon LB, Backer J. Relationship among self-efficacy, outcome expectancy, and postoperative behaviors in total joint replacement patients. Orthop Nurs, 2000, 19(2): 77-85.
13. 方漢萍, 杜杏利, 郭風勁, 等. 全髖關節置換術后不同時間開始康復訓練的效果研究. 中華護理雜志, 2006, 41(1): 16-19.
14. Johansson HR, Bergschmidt P, Skripitz R, et al. Impact of preoperative function on early post operative outcome after total hip arthroplasty. J Orthop Surg (Hong Kong), 2010, 18(1): 6-10.
15. Holtzman J, Saleh K, Kane R. Effect of baseline functional status and pain on outcomes of total hip arthroplasty. J Bone Joint Surg (Am), 2002, 84-A(11): 1942-1948.
16. Tateuchi H, Tsukagoshi R, Fukumoto Y, et al. Dynamic hip joint stiffness in individuals with total hip arthroplasty: relationships between hip impairments and dynamics of the other joints. Clin Biomech (Bristol, Avon), 2011, 26(6): 598-604.
17. Bin Nasser A, Beaulé PE, O’Neill M, et al. Incidence of groin pain after metal-on-metal hip resurfacing. Clin Orthop Relat Res, 2010, 468(2): 392-399.
18. 郭艾, 羅先正, 王志義, 等. 人工全髖關節置換術后康復治療和訓練計劃. 中國臨床康復醫學雜志, 1997, 12(5): 210-211.
19. Britton AR, Murray DW, Bulstrode CJ, et al. Pain levels after total hip replacement: their use as endpoints for survival analysis. J Bone Joint Surg (Br), 1997, 79(1): 93-98.

《中國修復重建外科雜志》

人工全髖關節置換術前康復干預對術后早期關節功能恢復的影響

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《中國修復重建外科雜志》

人工全髖關節置換術前康復干預對術后早期關節功能恢復的影響

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