杨家庆

【摘要】 目的：研究系統康复训练对老年股骨颈骨折髋关节置换术后髋关节功能的影响。方法：回顾性分析本院骨科就诊的共66例拟行人工髋关节置换术的老年患者，根据治疗方法不同分为对照组（n=31例）和研究组（n=35例）。对照组患者采用常规康复训练，研究组患者采用系统康复训练，对比两组患者术后日常生活活动能力、术后不同时间并发症发生情况、Harris评分和Barthel评分。结果：对照组患者中有13例（41.94%）在术后半年内能独立行走，研究组患者中有26例（74.29%）在术后半年内能独立行走，比较差异有统计学意义（P<0.05）。两组患者髋部疼痛等级优秀率比较差异有统计学意义（P<0.05）。两组患者出院时下肢深静脉血栓发生率对比差异有统计学意义（P<0.05）。两组患者术后3、6个月时各并发症发生率对比差异无统计学意义（P>0.05）。出院时两组患者Harris评分、Barthel评分对比差异无统计学意义（P>0.05），术后3、6个月研究组患者Harris评分和Barthel评分明显高于对照组，比较差异均有统计学意义（P<0.05）。结论：对老年人工髋关节置换术的患者采用系统有效的康复训练，可提高患者的术后日常生活活动能力，减少并发症发生，提高髋关节功能。

【关键词】 系统康复训练； 老年； 髋关节置换术； 日常生活活动能力； Harris评分； Barthel评分

【Abstract】 Objective：To study the effect of systematic rehabilitation training on hip joint function after hip arthroplasty in elderly patients with femoral neck fracture.Method：A total of 66 elderly patients undergoing artificial hip arthroplasty were enrolled in this retrospective study.The patients were divided into control group（n=31） and study group（n=35） according to different treatment methods.The control group patients received routine rehabilitation training.The study group received systematic rehabilitation training.The postoperative activities of daily living， postoperative complications，Harris score and Barthel score were compared between the two groups.Result：13 cases （41.94%） in the control group were able to walk independently within six months after operation.26 patients （74.29%） in the study group were able to walk independently within six months after operation，with statistical significance（P<0.05）. The two groups of patients with excellent grades of hip pain were statistically significant difference（P<0.05）.There was a significant difference in the incidence of DVT between the two groups when discharged from hospital（P<0.05）.There was no significant difference in complication rates between the two groups at 3 months and 6 months after operation（P>0.05）.There was no significant difference in Harris score and Barthel score between the two groups at discharge（P>0.05）.Harris score and Barthel score of the study group were significantly higher than those of the control group at the third month and the sixth month after operation Learning difference （P<0.05）.Conclusion：The systematic and effective rehabilitation training for elderly patients undergoing total hip arthroplasty can improve the postoperative activities of daily living，reduce the incidence of complications and improve the hip function.

【Key words】 Systemic rehabilitation training； Elderly； Hip arthroplasty； Activities of daily living；Harris score； Barthel score

First-authors address：Shenyang Medical College Affiliated Hospital，Shenyang 110024，China

doi：10.3969/j.issn.1674-4985.2018.04.038

老年人常合并多种慢性疾病，因此老年股骨颈骨折后需解决的关键问题为解除疼痛、恢复关节功能，重建髋关节[1]。系统的康复训练随着人工髋关节置换术的发展而变得越来越重要。术后功能的恢复好坏与手术是否成功以及术后康复训练是否系统、有效关系密切[2]。手术的治疗效果受到系统的康复训练的直接影响，尽快恢复老年患者的下肢运动功能，并能减少和预防各种并发症的发生。本研究对髋关节置换术患者采用康复训练，取得确切疗效，现报道如下。

1 资料与方法

1.1 一般资料 选取2011年3月-2016年8月于本院骨科就诊的共66例拟行人工髋关节置换术的老年患者，所有患者均符合人工髋关节置换术的适应证，纳入标准：（1）临床表现为有外伤史，髋部疼痛，活动受限。（……