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[1]龐智暉,曾偉恒,張穎,等.快速康復(fù)程序結(jié)合肌筋膜牽拉療法促進(jìn)全髖 置換患者康復(fù)的臨床研究[J].中醫(yī)正骨,2011,23(06):9-12.
　PANG Zhi-hui*,ZENG Wei-heng,ZHANG Ying,et al.Clinical study on the effect of the therapy of rapid rehabilitation procedures combined with myofascial traction on promoting the recovery of patients with total hip arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(06):9-12.
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快速康復(fù)程序結(jié)合肌筋膜牽拉療法促進(jìn)全髖 置換患者康復(fù)的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年06期
頁碼:
9-12
欄目:
臨床研究
出版日期:
2011-06-30

文章信息/Info

Title:
Clinical study on the effect of the therapy of rapid rehabilitation procedures combined with myofascial traction on promoting the recovery of patients with total hip arthroplasty
作者:
龐智暉1; 曾偉恒1; 張穎2; 魏秋實(shí)1
1.廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院,廣東 廣州 510407;
2.河南省洛陽正骨醫(yī)院,河南 洛陽 471002
Author(s):
PANG Zhi-hui*; ZENG Wei-heng; ZHANG Ying; et al.*
The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510407,Guangdong,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 髖 康復(fù) 靜脈血栓形成
Keywords:
Arthroplasty; Replacement; Hip;  Rehabilitation;  Venous thrombosis
摘要:
目的:觀察基于快速康復(fù)理念的快速康復(fù)程序結(jié)合肌筋膜牽拉療法對(duì)行全髖關(guān)節(jié)置換術(shù)患者的康復(fù)效果。方法:應(yīng)用隨機(jī)數(shù)字表將符合要求的97例行單側(cè)全髖關(guān)節(jié)置換的患者隨機(jī)分為3組:實(shí)驗(yàn)組32例,對(duì)照組34例,延期對(duì)照組31例。術(shù)后實(shí)驗(yàn)組和對(duì)照組患者即依照快速康復(fù)訓(xùn)練程序進(jìn)行康復(fù)治療,同時(shí)實(shí)驗(yàn)組患者在此基礎(chǔ)上辨證加用肌筋膜牽拉療法; 延期對(duì)照組患者于術(shù)后1周開始采用快速康復(fù)訓(xùn)練程序進(jìn)行鍛煉。分別于術(shù)前、術(shù)后第1周、第2周和3個(gè)月時(shí)依照Harris評(píng)分標(biāo)準(zhǔn)評(píng)定患髖功能。同時(shí)觀察各組并發(fā)癥的發(fā)生情況。結(jié)果:治療前后不同時(shí)間Harris評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(F=7.771,P=0.000)。處理方法和測(cè)量時(shí)間不存在交互效應(yīng)(F=0.170,P=0.960)。各處理組之間Harris評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(F=19.830,P=0.000),進(jìn)一步分析可知術(shù)前和術(shù)后3個(gè)月各組間比較,差異無統(tǒng)計(jì)學(xué)意義(F=2.060,P=0.175; F=13.886,P=0.068); 術(shù)后1周和術(shù)后2周各組間比較,差異有統(tǒng)計(jì)學(xué)意義(F=19.467,P=0.027; F=17.131,P=0.043)。再對(duì)術(shù)后1周和術(shù)后2周3組間做兩兩比較:①術(shù)后1周。實(shí)驗(yàn)組評(píng)分高于對(duì)照組和延期對(duì)照組,對(duì)照組評(píng)分高于延期對(duì)照組(P=0.035,P=0.001,P=0.045)。②術(shù)后2周。實(shí)驗(yàn)組和對(duì)照組評(píng)分均高于延期對(duì)照組(P=0.015,P=0.042),實(shí)驗(yàn)組與對(duì)照組評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(P=0.071)。對(duì)照組和延期對(duì)照組各有2例出現(xiàn)下肢深靜脈血栓形成; 實(shí)驗(yàn)組1例出現(xiàn)手術(shù)切口皮膚釘部分松動(dòng)脫落。各組均未出現(xiàn)感染、脫位等并發(fā)癥。結(jié)論:基于快速康復(fù)理念的快速康復(fù)程序結(jié)合肌筋膜牽拉療法能縮短全髖關(guān)節(jié)置換患者的康復(fù)時(shí)間,使其早期離床活動(dòng),有效降低相關(guān)并發(fā)癥的發(fā)生率,提高患者生活質(zhì)量。
Abstract:
Objective:To observe the rehabilitation efficacy of the therapy of rapid rehabilitation procedures based on rapid rehabilitation concept combined with myofascial traction on patients with total hip arthroplasty.Methods:97 patients with unilateral total hip arthroplasty were randomly divided into 3 groups according to the random number table,32 cases in the experimental group,34 cases in the control group and 31 cases in the deferred control group.After the operation,patients in the experimental group and control group were all administrated with rapid rehabilitation training procedures,meanwhile the patients in the experimental group were administrated with additional myofascial traction therapy according to differentiation of symptoms and signs; while the others in the deferred control group were administrated with rapid rehabilitation training procedures one week after the operation.Functions of the affected hips were evaluated according to Harris scoring standards before the operation,the 1st week,2nd week and 3 months after the operation respectively,and the complications for each group were observed at the same time.Results:There was statistical difference in Harris scores among different time points(F=7.771,P=0.000).There was no interaction effects between treatment process and measuring time points(F=0.170,P=0.960).On the aspect of Harris scores,there was statistical difference among the 3 groups(F=19.830,P=0.000).However,a further analysis showed that there was no statistical difference among the 3 groups 3 months after the operation and before the operation(F=2.060,P=0.175; F=13.886,P=0.068),and there was statistical difference among the 3 groups 1 week and 2 weeks after the operation(F=19.467,P=0.027; F=17.131,P=0.043).The results of pairwise comparison showed:①One week after the operation,scores of experimental group were higher than those of control group and deferred control group,and scores of control group were higher than those of deferred control group(P=0.035,P=0.001, P=0.045); ②Two weeks after the operation,scores of experimental group and control group were higher than those of deferred control group(P=0.015,P=0.042),and there was no statistical difference in scores between experimental group and control group(P=0.071).2 cases with deep vein thrombosis in lower limbs were found in control group and deferred control group respectively,1 case of partly looseness of nail in the operational incision was found in the experimental group.No infection,dislocation and other complications were found in each group.Conclusion:The therapy of rapid rehabilitation procedures based on rapid rehabilitation concept combined with myofascial traction can shorten the rehabilitation time for the patients with total hip arthroplasty,then make them carry out ambulation earlier,which decrease the incidence of complications effectively and improve their life quality.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣州中醫(yī)藥大學(xué)中醫(yī)藥科研創(chuàng)新基金項(xiàng)目(10CX004)
更新日期/Last Update: 2011-06-30