吴小青 王波

[摘要] 目的 探讨阶段性递增功能锻炼对髋关节置换术后患者功能恢复的作用。 方法 选取2016年1月～2019年10月在我院拟行髋关节置换术治疗的患者92例，随机分为干预组和对照组，每组46例。两组均行髋关节置换术。对照组术后予常规功能训练，干预组在对照组基础上予阶段性递增功能锻炼，两组均干预3个月。观察两组术后住院时间、骨折愈合时间和并发症的发生率，并比较疼痛情况变化和髋关节功能恢复情况。 结果 干预组术后住院时间和骨折愈合时间明显短于对照组（P<0.05）。干预组术后发生并发症3例（6.52%），对照组发生10例（21.74%），干预组术后并发症的发生率低于对照组（P<0.05）。干预3个月后，两组VAS评分较干预前明显下降（P<0.05或P<0.01），且干预组下降幅度较对照组更明显（P<0.05）;同时干预组髋关节功能优良率（89.13%）高于对照组（71.74%）（P<0.05）。 结论 阶段性递增功能锻炼用于髋关节置换术后患者不仅有利于术后康复，缩短术后住院时间，促进骨折愈合，减少术后并发症发生，而且可明显减轻患者术后疼痛症状，改善髋关节功能。

[關键词] 髋关节置换术后;阶段性递增功能锻炼;并发症;术后疼痛;髋关节功能

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2020）18-0055-04

Efficacy of stage incremental functional exercise on functional recovery of patients after hip replacement

WU Xiaoqing   WANG Bo

Department of Surgery， the Peoples Hospital of Lishui City in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To investigate the efficacy of stage incremental functional exercise on functional recovery of patients after hip replacement. Methods From January 2016 to October 2019， ninety-two patients who underwent hip replacement in our hospital were randomly divided into the intervention group（n=36） and the control group（n=36）. Both groups underwent hip replacement. The control group received routine functional exercise after operation， and the intervention group received stage incremental functional exercise based on the control group. Both groups received intervention for three months. The postoperative hospitalization time， fracture healing time and incidence of complications were observed， and the changes of pain and hip joint function recovery were compared between the two groups. Results The postoperative hospitalization time and fracture healing time in the intervention group were significantly shorter than those in the control group（P<0.05）. Postoperative complications happened in three cases（6.52%） in the intervention group and ten cases（21.74%） in the control group. The incidence of postoperative complications in the intervention group was lower than that in the control group（P<0.05）. After three months of intervention， the VAS score of the two groups decreased significantly（P<0.05 or P<0.01） compared with that before the intervention， and the decrease in the intervention group was more significant than that in the control group（P<0.05）. At the same time， the excellent and good rate of hip joint function in the intervention group（89.13%） was higher than that in the control group（71.74%）（P<0.05）. Conclusion Stage incremental functional exercise for patients after hip replacement is not only beneficial to postoperative rehabilitation， shortening postoperative hospitalization time， promoting fracture healing and reducing postoperative complications， but also significantly reduces postoperative pain symptoms of patients and improves hip joint function.

[Key words] Postoperative hip replacement; Stage incremental functional exercise; Complications; Postoperative pain; Hip joint function

髋关节疾病是骨科常见病和多发病，近年来随着人口老龄化的加剧，股骨颈骨折及股骨头坏死等髋关节疾病发病率呈上升趋势[1，2]。人工髋关节置换术是指用金属或高分子聚乙烯陶瓷等材料，根据人体关节的形态构造及功能制成人工假体，并通过外科手术将人工假体植入体内，取代病变髋关节的手术。人工髋关节置换术是目前治疗晚期髋关节疾病最有效的手段，能有效矫正关节畸形，恢复髋关节功能，减轻关节疼痛，其疗效已受临床肯定[3，4]。但人工髋关节置换术术后仍需进行较长时间的功能锻炼以恢复髋关节功能，而髋关节功能恢复的好坏与术后能否坚持严格功能锻炼计划有很大关系[5，6]。近年来研究发现阶段性递增功能锻炼对髋关节置换术后患者关节功能提高具有积极的作用[7，8]。……