髋膝关节置换后下肢肿胀分度及早期预防  

The severity and early prevention of lower limbs swelling caused by total hip or/and knee replacement： a prospective comparative study

作　　者：黄小强[1] 廖永华[1] 王效东[1] 

机构地区：[1]西安市红十字会医院,710054

出　　处：《美中国际创伤杂志》2005年第3期15-17,共3页U.S.Chinese International Journal of Traumatology

基　　金：本项目为2003年度西安市科技攻关项目,项目编号：SF200304

摘　　要：目的：制定人工关节置换术后下肢肿胀的分度标准，对比观察术后早期持续被动活动（continuous passive motion，CPM）对肿胀的预防作用。方法：自2001年6月～2004年10月对接受人工全髋、膝关节置换术的患者128例（144个关节）根据术后处理办法的不同，前瞻性地将其随机分成A组（手术8h后利用CPM机进行患肢持续被动活动功能锻炼）和B组（手术一周后开始进行CPM机功能锻炼）。手术后第4d观察两组患者下肢的肿胀情况，根据制定标准评分，分为轻、中、重度肿胀，统计每组中、重度肿胀的病例数，采用SPSS10．0统计分析软件进行统计学分析。结果：A组69个关节（62例患者）中有10侧下肢出现不同程度肿胀，B组75个关节（66例患者）中有25侧下肢呈不同程度肿胀，经统计学分析差异有显著性意义（P〈0．05）。结论：人工关节置换术后早期进行患肢持续被动活动对手术后肢体肿胀有明显的预防作用。可以作为关节置换术后早期预防深静脉血栓形成的常规疗法之一。Objective： To establish a new method of classification for the degree of lower limb swelling after total hip or/and knee replacement and evaluate the curative effect of continuous passive motion in prevention of leg swelling. Methods： From June 2001 to October 2004, we performed total hip or/and knee replacement on 128 patients （144 joints）, 70 male （82 joints） and 58 female （62 joints）, with an average age of （58.7±20.6） years （ranging from 38 to 80 years）. The patients were randomly divided into 2 treatment groups. Group A patients （62 eases, 69 joints） start CPM 8 hours after operation anti group B patients （66 cases, 75 joints） start CPM one week later. At the 4th post-op day. the status of leg swelling was observed and classified as slight, midrange and severe swelling according to the new criterion. After that, we calculated the numbers of midrange and severe swelling cases and analyzed it bv using SPSS 10.0 Slat. software. Results： Different degree of leg swelling was noted on 10 eases in group A anti 25 eases in group B. There was a significant difference （P〈0.05）. Conclusion： Early continuous passive motion can prevent lower limbs swelling after total hip or/and knee replacement. It ean be used as one of the routine treatment to prevent the deep vein thrombosis after total joint replacement.

关 键 词：运动疗法 持续被动性 关节成形术 置换 并发症 预防 

分 类 号：R687.4[医药卫生—骨科学]