髋膝关节置换术后患者居家康复依从性的调查研究  

Investigation of home-based rehabilitation compliance in patients after hip or knee arthroplasty

作　　者：林阳阳[1] 李文昌 陈晓玲[2] 邓禹杰 冯慧婷 徐洋凡 廖威明[2] 邬培慧[2] Lin Yangyang;Li Wenchang;Chen Xiaoling;Deng Yujie;Feng Huiting;Xu Yangfan;Liao Weiming;Wu Peihui(Center for Rehabilitation Medicine,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院康复医学中心,广州510655 [2]中山大学附属第一医院关节外科,广州510080

出　　处：《新医学》2020年第10期747-751,共5页Journal of New Medicine

基　　金：广东省重大科技项目(2017B020227005,2016B090916002);广东省科技计划项目(2019A141401002);广州市科技计划项目(20180290039);中山大学青年教师培育项目基金资助项目(20ykpy69)。

摘　　要：目的探讨髋膝关节置换术后患者居家康复依从性,分析影响该类患者术后居家康复依从性的原因。方法对初次行全髋关节或全膝关节置换术的300例患者随访1年,利用微信发放电子问卷结合电话沟通,进行手术满意度评分、下肢关节功能恢复满意度评分、近期关节疼痛评分,记录非疲劳步行距离、居家康复训练的类型和持续时间以及未能坚持居家康复训练的原因、对康复训练的需求等。结果随访率为71.0%(213/300)。213例患者手术满意度评分为10(8,10)分;下肢关节功能恢复满意度评分为8(7,10)分;近期关节疼痛评分为2(1,4)分;非疲劳步行距离为550(500,1500)m。患者居家康复训练内容主要为下肢关节活动度范围练习、下肢肌肉力量训练以及下肢平衡练习,仅23.5%(50/213)患者坚持居家康复3个月及以上,9.4%(20/213)患者能坚持1年以上,24.9%(53/213)患者未进行术后康复训练。患者居家康复训练的需求主要为观看康复视频、康复图文资料及电话随访。患者术后未能坚持居家康复训练的主要原因包括无人指导(49.1%)、不方便出行(24.5%)、无体能执行康复方案(22.6%)。结论髋膝关节置换术后患者居家康复训练的依从性较低,影响因素主要为缺乏专业人员指导、体能不足以完成康复训练方案及出行受限。Objective To investigate the home-based rehabilitation compliance and analyze its influencing factors of patients after hip or knee arthroplasty.Methods A total of 300 patients who initially underwent total hip/knee arthroplasty were recruited and followed up for one year.The electronic questionnaire was distributed via Wechat software and telephone inquiry was delivered to evaluate the patient satisfaction score after surgery,satisfaction score of functional recovery of the lower limb joints,score of recent joint pain,record the non-fatigue walking distance,type and duration of home-based rehabilitation exercise,the reasons of not taking rehabilitation exercise and the requirement for rehabilitation exercise,etc.Results The followup rate was 71%(213/300).The patient satisfaction score after surgery was 10(8,10).The score of functional recovery of the lower limb joints was 8(7,10).The score of recent joint pain was 2(1,4).The non-fatigue walking distance was 550(500,1500)m.Home-based rehabilitation exercise mainly included the exercise of the range of motion of the lower limb joints,and muscle strength and balance of the lower limbs.Merely 23.5%(50/213)of the patients adhered to home-based rehabilitation exercise for 3 months or longer,9.4%for more than one year of rehabilitation exercise,and 24.9%of them failed to take rehabilitation exercise.The requirement for home-based rehabilitation exercise primarily consisted of watching rehabilitation videos,graphic and text materials and telephone follow-up.The reasons for not taking home-based rehabilitation exercise mainly included lack of professional guidance(49.1%),inconvenient going-out(24.5%)and inability to complete the rehabilitation exercise(22.6%).Conclusions The compliance of patients with home-based rehabilitation exercise after hip or knee arthroplasty is relatively low.The influencing factors mainly include lack of professional guidance,poor physical reserve and inconvenient going-out.

关 键 词：全髋关节置换术 全膝关节置换术 居家康复 依从性 

分 类 号：R687.4[医药卫生—骨科学] R493[医药卫生—外科学]