多元化康复干预对外固定支架下肢延长术后患者关节功能康复的影响  

Effect of diversified rehabilitation intervention on rehabilitation of joint function of external fixator for lower limb lengthening

作　　者：梁凤芝 秦瑜[1] 周玲[1] 钱会娟[1] 胡三莲[1] Liang Fengzhi;Qin Yu;Zhou Ling;Qian Huijuan;Hu Sanlian(Department of Orthopaedics,Sixth People's Hospital Affiliated to Shanghai JiaoTong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《中国医学前沿杂志（电子版）》2020年第3期150-154,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：上海市第六人民医院院级科学研究基金项目(院内-2038)。

摘　　要：目的探讨多元化康复干预对外固定支架下肢延长术后患者关节功能康复的影响。方法选取2017年8月至2018年9月于上海交通大学附属第六人民医院行下肢单边外固定支架延长的180例患者为研究对象,将其随机分为研究组(90例)和对照组(90例),对照组患者接受常规康复干预和指导,研究组患者接受多元化康复干预,包括钉道处理、支架调整、关节松动、功能锻炼、中药熏洗、拆除外固定支架等方面,并通过微信接受康复干预指导。比较两组患者出院前和出院后1、3、6个月髋关节、膝关节和踝关节功能。结果两组患者出院后1、3、6个月Harris髋关节评分(Harris hip score,HHS)、美国特种外科医院(hospital for special surgery,HSS)评分、美国足踝外科学会(American Orthopaedic Foot and Ankle Society,AOFAS)评分较本组出院前均逐渐提高(均P<0.05),且研究组患者出院后1、3、6个月上述3项评分均显著高于同期对照组(均P<0.05)。两组患者出院后6个月外固定支架延长长度比较差异无统计学意义(P>0.05)。研究组患者神经损伤、延迟愈合、关节畸形、肌肉挛缩发生率均显著低于对照组(均P<0.05)。结论多元化康复干预能明显促进外固定支架下肢延长术后患者关节功能的康复,降低并发症发生风险。Objective To investigate the effect of diversified rehabilitation intervention on rehabilitation of joint function of external fixator for lower limb lengthening.Method One hundred and eighty patients who underwent mono-lateral external fixation for lower limb lengthening in Sixth People's Hospital Affiliated to Shanghai JiaoTong University from August 2017 to September 2018 were prospectively enrolled for the study,and they were randomly divided into study group and control group,90 cases in each group.Patients in control group were given routine rehabilitation intervention and guidance.Patients in study group were given diversified rehabilitation intervention,including nail path treatment,stent adjustment,joint loosening,functional exercise,Chinese medicine fumigation and washing,removal of external fixator through rehabilitation intervention guidance of Wechat.The function of hip,knee and ankle joints were compared before discharge and 1,3,6 months after discharge between the two groups.Result The Harris hip score(HHS),hospital for special surgery(HSS)score and American Orthopaedic Foot and Ankle Society(AOFAS)score in the two groups gradually increased after discharge(all P<0.05),and these scores at 1,3 and 6 months after discharge in study group were significantly higher than those in control group during the same period(all P<0.05).There was no significant difference in the extended length of external fixing bracket at 6 months after discharge between the two groups(P>0.05).The incidences of nerve injury,delayed healing,joint deformity and muscle contracture in study group were significantly lower than those in control group(all P<0.05).Conclusion Diversified rehabilitation intervention can obviously promote the rehabilitation of joint function after external fixation for lower limb lengthening,and reduce the risk of complications.

关 键 词：多元化康复干预 肢体延长术 微信平台 并发症 

分 类 号：R687.3[医药卫生—骨科学]