丁海燕　沈松梅

[摘要] 目的 探讨开展护理查房式的健康教育活动对人工髋关节置换术患者功能锻炼依从性的影响。 方法 选择2011年1月～2014年12月上海市某家三级综合性医院骨科收治住院的人工髋关节置换术患者131例，以2011年1月～2012年12月53例患者为对照组，以2013年1月～2014年12月78例患者为观察组。对照组按常规传统方法对人工髋关节置换术患者进行术后护理与康复训练；观察组在对照组所使用的常规传统方法基础上增加针对性护理查房形式的健康教育活动，比较两组患者功能锻炼依从性，术后并发症发生率和护理满意度。 结果 观察组患者功能锻炼的依从性显著优于对照组（P<0.01），术后并发症（DVT）显著低于对照组（P<0.01），患者护理满意度调查显著高于对照组（P<0.01）。 结论 护理查房形式的健康教育活动针对人工髋关节置换术患者术后功能锻炼依从性这一难点，开展多途径、有针对性和积极主动的护理实践，有效地帮助患者形成正确的功能锻炼行为和观念，提高了功能锻炼的依从性，降低和减少了并发症。

[关键词] 健康教育；人工髋关节置换术；功能锻炼；依从性

[中图分类号] R473.6 [文献标识码] B [文章编号] 2095-0616（2015）24-127-04

[Abstract] Objective To explore the Effect of health education on compliance of functional exercise in hip joint replacement. Methods 131 cases of total hip arthroplasty were selected from the Department of orthopedics of three grade general hospital in Shanghai from January 2011 to December 2014. 53 patients between January 2011 and December 2012 were in the control group， with 78 patients from January 2013 to December 2014 as the observation group. After treated with the traditional method of artificial hip replacement， the control group were given conventional nursing and rehabilitation training. In the control group used the conventional method based on， the control group was increased in nursing ward round form of health education activities. Compliance of functional exercise， incidence rate of postoperative complications and nursing satisfaction of two groups were compared. Results Functional exercise compliance of observation group was significantly better than that of the control group （P<0.01）. Postoperative complications （DVT） of observation group was significantly lower than that of the control group （P<0.01）， and the patients' satisfaction with nursing of observation group was significantly higher than that of the control group （P<0.01）. Conclusion Nursing rounds forms of health education activities for after artificial hip joint replacement patients with functional exercise compliance in this difficult， to carry out multi way， pertinence and initiative of nursing practice and effectively help patients form a correct function exercise behavior and concept， improve the functional exercise compliance， and reduce the complications.

[Key words] Health education； Total hip replacement； Functional exercise； Compliance

股骨颈骨折是常见骨折之一，约占全身骨折的3.58%，占髓部骨折的54%[1]。随着假体技术的日益发展，股骨头置换术和髋关节置换术在股骨颈骨折中的应用日趋广泛。假体置换克服了骨折不愈合、股骨头坏死等问题，允许患者早期下床活动，降低了并发症的发生，缩短了治疗时间，提高了患者的生活质量。下肢深静脉血栓（deep venous thrombosis，DVT）形成、假体脱位、肺部感染、关节僵硬、压疮、便秘等是人工髋关节置换术后常见的并发症。endprint

人工髋关节置换术患者术后正确、积极、有效的功能锻炼能促进机体恢复功能，最大限度的改善神经肌肉关节的功能，有效防止并发症，术后晚期的训练则能积极提高患肢功能康复效果[2]。……