持续性被动锻炼康复护理对行跟骨外侧壁骨皮瓣截骨入路跟骨关节内骨折患者的效果  

Effect of continue passive motion rehabilitation nursing on the treatment of intraarticular calcaneal fracture patients who underwent the approach of calcaneal lateral wall flap osteotomy

作　　者：黄卫平[1] 李玉梅[1] 颜薛丽 王斌[1] 

机构地区：[1]浙江省台州医院骨科综合病区,浙江台州317000

出　　处：《中国现代医生》2017年第13期139-143,146,共6页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(A类)(2014KYA226)

摘　　要：目的观察持续性被动锻炼康复护理对行跟骨外侧壁骨皮瓣截骨入路跟骨关节内骨折患者的效果。方法选择2014年4月~2015年12月在我院接受手术治疗的跟骨关节内移位骨折患者114例作为研究对象,所有患者均采用"L"形切口、跟骨外侧壁骨皮瓣截骨入路方式。采用随机数字表法将其随机分为对照组和观察组,每组57例。其中对照组患者接受常规护理,观察组患者接受持续性被动锻炼联合康复护理,比较两组骨折愈合时间;对患者进行随访,比较两组患者手术后12个月时的跟骨复位率、Bohler角、Gissane角、及Maryland足部评分系统评分及切口相关并发症发生率;术后6个月时应用SF-36生活质量量表对两组患者的生活质量进行评估。结果 (1)观察组患者骨折愈合时间明显短于对照组,Bohler角、Gissane角恢复情况明显优于对照组,切口相关并发症发生率明显低于对照组(P<0.05);(2)观察组患者跟骨高度和宽度的复位率明显优于对照组(P<0.05);(3)术后观察组患者Maryland足部评分明显优于对照组(P<0.05);(4)两组患者护理干预后各项生活质量评分均明显提高,且观察组各项评分均明显高于对照组(P<0.05)。结论持续性被动锻炼联合康复护理应用于行跟骨外侧壁骨皮瓣截骨入路术的跟骨关节内骨折患者效果显著,可获得满意的复位效果,能有效减少软组织并发症的发生,促进患者术后踝关节功能的恢复,还可大幅改善患者的生活质量,临床应用价值较高,值得推广应用。Objective To observe the effect of continue passive motion rehabilitation care on the treatment of intraarticular calcaneal fracture patients who underwent the approach of ealcaneal lateral wall flap osteotomy. Methods A total of 114 patients with intra-articular fractures treated with surgery in our hospital from April 2014 to December 2015 were chosen. All patients underwent an ＂L＂ -shaped incision and the calcaneal lateral wall flap osteotomy approach. The patients were randomly divided into control group and observation group, with 57 cases in each group. The patients in the control group were treated with routine nursing care. The patients in the observation group received continue passive motion combined with rehabilitation nursing. The healing time between the two groups was compared.The patients in the two groups were followed up to compare calcaneus reduction rate, Bohter angle, Gissane angle, and Maryland foot scoring system score and incision-related complication rate at 12 months after operation. Meanwhile, the quality of life in patients between the two groups was assessed by the SF-36 Quality of Life Scale at 6 months after surgery. Results （1） The time of fracture healing was significantly shorter in the observation group than that in the control group, and the recovery status of Bohler angle and Gissane angle was significantly better than that of the control group. The incidence of incision-related complications was significantly lower than that of the control group（P〈0.05）. （2）The resection rate of calcaneus height and width in the observation group was significantly better than that in the control group. （3）The Maryland foot score of the observation group was significantly better than that of the control group （P〈0.05）. （4）The scores of the quality of life in the two groups were significantly improved after nursing intervention. And the scores of the observation group were significantly higher than those of the control group （P〈0.05）. Conclusion Continue pas

关 键 词：跟骨关节内骨折 骨折内固定 持续性被动锻炼 康复护理 

分 类 号：R687.3[医药卫生—骨科学]