高龄髋部术后足踝运动方法对下肢静脉回流影响的临床观察  

The effect of ankle movements on the venous return in the lower limb for the aged patients with hip replacement

作　　者：库洪安[1] 詹燕[2] 崔伯艳[1] 岳建伟[1] 

机构地区：[1]解放军总医院南楼临床部外一科一病区,北京100853 [2]解放军总医院第一附属医院胸心外科

出　　处：《中国骨伤》2011年第1期75-77,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察高龄髋关节置换术后足踝屈伸运动时不同的运动角度与持续时间对小腿肌群挤压深静脉增加血流速度的效果,探讨最佳的足踝屈伸运动角度与持续时间。方法:选择2009年10月至2010年8月收治的高龄髋部外伤行择期全髋或半髋关节置换术的患者17例。其中股骨颈骨折8例,股骨粗隆骨折9例;年龄80～96岁,平均87岁;男11例,女6例。用彩色超声多普勒检测患者术后第2天患侧股静脉在足踝屈伸不同角度与不同持续时间状态下的血流动力学指标(血流峰速度),并进行统计学分析。结果:不同角度的血流峰速度与静息状态[(29.2±3.4)cm/s]比较,足踝跖屈30°背伸20°持续时间2秒/次[(38.1±6.2)cm/s]、3秒/次[(37.9±6.4)cm/s]及足踝跖屈45°背伸30°5个持续时间[持续时间1～5秒/次分别为(40.6±7.9)、(52.6±7.0)、(48.8±7.1)、(42.1±6.3)、(39.3±5.7)cm/s]差异有统计学意义(P<0.01);足踝跖屈30°背伸20°持续时间2秒/次与3秒/次比较无统计学意义(P>0.05);足踝跖屈45°背伸30°各持续时间与足踝跖屈30°背伸20°持续时间2秒/次比较:足踝跖屈45°背伸30°持续时间2、3秒/次时差异有统计学意义(P<0.01);持续时间为4秒/次也有统计学意义(P<0.05)。结论:高龄髋外伤围手术期卧床期间足踝运动角度以跖屈45°背伸30°,运动持续时间以2秒/次和3秒/次最佳,可显著地增加股静脉血流速度。Objective：To explore the effect of ankle dorsiflexion and extension in different angles and persistence time on increasing the velocities of femoral venous blood flow（FVBF） in aged patients with hip replacement and to find the best angle and persistence time. Methods：From Oct.2009 to Aug.2010,17 aged patients with hip replacement in General Hospital of PLA were choosed in the study. Eight patients suffered from femoral neck fracture and 9 patients suffered from femoral intertrochanteric fracture. There were 11 males and 6 females,ranging in age from 80 to 96 years,averaged 87 years. At the 2nd day after operation,the femoral venous peaking velocities were detected by color ultrasound Doppler in different angle and persistence time of ankle dorsiflexion and extension. The data were analyzed by statistics software. Results：Among the results between different athletic angles and ankle quiescent condition,the ankle dorsiflexion 30°extension 20°,2 seconds every time[（38.1±6.2） cm/s],3 seconds every time[（37.9±6.4） cm/s]and the 5 time of ankle dorsiflexion 45°extension 30°[the femoral venous peaking velocities were respectively （40.6±7.90）,（52.6±7.0）,（48.8±7.1）,（42.1±6.3）,（39.3±5.7） cm/s] were higher（P0.01）. There was no significant difference in ankle dorsiflexion 30° extension 20° between 2 seconds and 3 seconds（P0.05）. All time of ankle dorsiflexion 45° extension 30° compared with 2 seconds every time of ankle dorsiflexion 30° extension 20°,2 seconds and 3 seconds every time of ankle dorsiflexion 45° extension 30° were higher （P0.01）;4 seconds every time also were higher（P0.05）. Conclusion：The best persistence time of ankle movements for the aged patients with hip operation is ankle dorsiflexion 45° extension 30°,2 seconds and 3 seconds every time. It can significantly increase blood flow velocity of femoral veins.

关 键 词：髋 外伤 髋假体 踝关节 超声检查 多普勒 彩色 血流速度 动力学 老年人 80以上 

分 类 号：R473.6[医药卫生—护理学]