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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第24卷

期數(shù):

2012年10期

頁碼:

29-32

欄目:

臨床研究

出版日期:

2012-10-20

文章信息/Info

Title:

Application of exercise therapy combined with oral QIANG GU DRINK in the postoperative rehabilitation of femoral intertrochanteric fracture

作者:

孫國麗¹; 倪力剛²; 史曉林¹

1.浙江中醫(yī)藥大學(xué)附屬第二醫(yī)院,浙江 杭州 310005;
2.浙江中醫(yī)藥大學(xué)第二臨床醫(yī)學(xué)院,浙江 杭州 310053

Author(s):

SUN Guo-li^*; NI Li-gang; SHI Xiao-lin.

^*The Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,Zhejiang,China

關(guān)鍵詞:

髖骨折 轉(zhuǎn)子間骨折 運動療法 強骨飲

Keywords:

Hip fractures;  Intertrochanteric fractures;  Exercise therapy;  QIANG GU DRINK

摘要:

目的:探討運動療法聯(lián)合強骨飲口服在股骨轉(zhuǎn)子間骨折術(shù)后康復(fù)治療中的療效和安全性。方法:60例股骨轉(zhuǎn)子間骨折術(shù)后患者,隨機分為2組。治療組32例,男10例,女22例; 年齡60～89歲,中位數(shù)70.5歲。對照組28例,男7例,女21例; 年齡61～87歲,中位數(shù)69.5歲。治療組采用運動療法聯(lián)合強骨飲口服綜合治療,對照組僅采用運動療法治療。觀察比較2組患者術(shù)后下床時間、骨折愈合、骨密度改善、髖關(guān)節(jié)功能及并發(fā)癥發(fā)生情況。結(jié)果:60例患者均獲隨訪,隨訪時間6～18個月,中位數(shù)12.5個月。治療組術(shù)后下床時間為35～60 d,中位數(shù)47.5 d; 對照組術(shù)后下床時間為50～80 d,中位數(shù)65.5 d,治療組患者術(shù)后下床時間早于對照組(t=-8.900,P=0.000)。骨折均愈合; 治療組骨折愈合時間2～4個月,中位數(shù)3.5個月; 對照組骨折愈合時間3～9個月,中位數(shù)6.5個月,治療組骨折愈合時間短于對照組(t=-9.207,P=0.000)。治療組切口感染1例,經(jīng)換藥及抗感染治療半個月后切口愈合。對照組切口感染2例,經(jīng)過換藥及抗感染治療1個月后切口愈合; 肺部感染2例,經(jīng)抗感染治療后癥狀緩解; 泌尿系感染1例,經(jīng)抗感染治療后癥狀緩解; 下肢深靜脈血栓1例,轉(zhuǎn)入血管外科行手術(shù)治療后癥狀緩解。2組術(shù)后并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學(xué)意義(χ2=3.241,P=0.072)。術(shù)前2組患者骨密度的差異無統(tǒng)計學(xué)意義(t=1.059,P=0.294); 術(shù)后1年,治療組骨密度高于對照組(t=2.607,P=0.012); 2組患者骨密度均較治療前改善,且治療組改善優(yōu)于對照組(t=13.639,P=0.000)。參照美國矯形外科研究院髖關(guān)節(jié)評價標(biāo)準(zhǔn)評定療效,治療組優(yōu)20例,良8例,可4例; 對照組優(yōu)13例,良5例,可10例; 治療組療效優(yōu)于對照組(Z=-2.317,P=0.021)。結(jié)論:在轉(zhuǎn)子間骨折的術(shù)后康復(fù)中應(yīng)用運動療法聯(lián)合強骨飲口服,可提高骨密度,促進骨折愈合,縮短患者下地時間,有利于髖關(guān)節(jié)功能恢復(fù),比單純運動康復(fù)治療療效更顯著,且不良反應(yīng)少。

Abstract:

Objective:To explore the curative effect and safety of exercise therapy combined with oral QIANG GU DRINK in the postoperative rehabilitation treatment of femoral intertrochanteric fracture.Methods:Sixty postoperative patients with femoral intertrochanteric fracture were randomly divided into 2 groups.Thirty-two patients was in the treatment group,male 10 cases,while female 22 cases,ranging in age from 60 to 89 years with a median of 70.5 years; while the others was in the control group,male 7 cases,while female 21 cases,ranging in age from 61 to 87 years with a median of 69.5 years.Patients in the treatment group were administrated with exercise therapy combined with oral QIANG GU DRINK,while the others in the control group were administrated with exercise therapy only.The bed rest time,fracture healing process,improvement of bone mineral density(BMD),hip function and complications of patients were observed and compared between the 2 groups.Results:Sixty patients were all followed up,ranging in follow-up time from 6 to 18 months with a medium of 12.5 months.For patients in the treatment group,the bed rest time ranged from 35 to 60 days with a median of 47.5 days; while that time for cases in the control group ranged from 50 to 80 days with a median of 65.5 days; and the bed rest time for patients in the treatment group was shorter than that in the control group(t=-8.900,P=0.000).The fractures were all healed.The fracture healing time of treatment group ranged from 2 to 4 months with a median of 3.5 months,while that time of control group ranged from 3 to 9 months with a median of 6.5 months,and the fracture healing time of treatment group was shorter than that of control group(t=-9.207,P=0.000).One case with incision infection was found in treatment group and was healed after dressing change combined with anti-infective treatment for half of a month.For patients in the control group,2 cases with incision infection were found and were healed after dressing change combined with anti-infective treatment for 1 month; 2 cases with pulmonary infection and 1 case with urinary infection were found,whose symptoms were alleviated after anti-infective treatment,and one case with deep venous thrombosis was found,whose symptom was alleviated after operative treatment in vascular surgery department.There was no statistical difference in postoperative complications between the 2 groups(χ2=3.241,P=0.072).There was no statistical difference in BMD of patients between the 2 group before the treatment(t=1.059,P=0.294); while BMD of treatment group was higher than that of control group 1 year after operation(t=2.607,P=0.012).BMD of patients in the 2 groups increased after the treatment and the patients in the treatment group got more significant improvement in BMD compared with the patients in the control group(t=13.639,P=0.000).The curative effect was evaluated according to evaluation criterion of hip junction of American Orthopaedic Academy.Twenty patients had excellent outcomes,8 patients had good outcomes and 4 patients had fair outcomes in the treatment group; while 13 patients had excellent outcomes,5 patients had good outcomes and 10 patients had fair outcomes in the control group; and the curative effect of treatment group was better than that of control group(Z=-2.317,P=0.021).Conclusion:It can increase BMD,promote fracture healing and shorten the bed rest time by application of exercise therapy combined with oral QIANG GU DRINK in the postoperative rehabilitation of femoral intertrochanteric fracture,and it is beneficial for recovery of joint function of hip and has more significant curative effect and less adverse reactions.

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更新日期/Last Update: 2012-10-20