姚允萍 耿硕

[摘要] 目的 探究阶段性康复功能锻炼在股骨颈骨折行髋关节置换术后的临床应用。 方法 选择哈尔滨医科大学附属第一医院2013年7月～2015年7月收治的90例股骨颈骨折行髋关节置换术患者，采取随机数字表法分为观察组（45例）与对照组（45例）。比较两组患者临床效果，护理前后的日常生活能力评分、视觉模拟（VAS）评分，随访3个月内的Harris髋关节评分。 结果 观察组总有效率明显高于对照组，差异有统计学意义（P < 0.05）。两组护理前Barthel指数、VAS评分差异无统计学意义（P > 0.05），两组护理后较治疗前Barthel指数升高，VAS评分降低，但观察组较对照组改善更加明显，差异有统计学意义（P < 0.05）。观察组与对照组比较，随访1、2、3个月Harris髋关节评分明显提高，差异有统计学意义（P < 0.05）。 结论 将阶段性康复功能锻炼应用于股骨颈骨折行髋关节置换术后可显著提高临床护理效果，改善日常生活能力，促进术后恢复。

[关键词] 阶段性康复功能锻炼；股骨颈骨折；髋关节置换术

[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210（2016）03（c）-0112-04

[Abstract] Objective To explore the clinical application of stage rehabilitation exercise in moral neck fracture after hip arthroplasty. Methods From July 2013 to July 2015， in the First Affiliated Hospital of Harbin Medical University， 90 parients with femoral neck fracture treated with line hip replacement were selected， accoding to random number table， they were divided into observation group （45 cases） and control group （45 cases）. Clinical effect， daily life ability score and VAS score， the before and after nursing， Harris hip score followed up for 3 months were compared. Results The total effective rate of observation group was obviously higher than that of control group， the difference was statistically significant （P < 0.05）. Before nursing care， Barthel index， VAS score of two groups were compared， the differences were not statistically significant （P > 0.05）； after nursing care， the Barthel index of two groups increased and VAS score decreased compared with before nursing care， and those in the observation group improved more obviously than those in the control group， the differences were statistically significant （P < 0.05）. Harris hip score of observation followed up for 1， 2， 3 months were higher than those in the control group， the differences were statistically significant （P < 0.05）. Conclusion Periodic rehabilitation exercise applied to femoral neck fracture after hip arthroplasty can significantly improve the effect of clinical nursing， improving daily living ability， and promoteing postoperative recovery.

[Key words] Stage rehabilitation exercise； Femoral neck fracture； Hip replacement

目前，隨着社会的不断发展，人口老龄化趋势的加重，股骨颈骨折的发病率呈逐年上升趋势。大量临床研究资料显示，由于股骨颈具有独特的生理解剖结构及功能，在临床治疗方面多存在较大的困难，其中人工髋关节置换术凭借其可迅速缓解临床症状，恢复关节及肢体功能，并可有效促进患者早期下床活动[1]。但由于行髋关节置换术可在一定程度上对关节活动、日常生活造成影响，影响术后康复，为患者带来身心上的痛苦，并有可能诱发并发症。为此，采取积极有效的护理方法至关重要[2]。现临床上采用的常规护理方法在确保临床护理效果，改善日常生活能力，促进术后康复锻炼方面有限，因此，采用一种积极有效的护理方法应用于髋关节置换术治疗股骨颈骨折中至关重要[3]。……