全髋关节置换手术患者康复效果的影响因素及与脂肪质量指数的相关性分析  

Influencing factors of rehabilitation outcomes in patients undergoing total hip replacement and their correlation with fat mass index

作　　者：杨立 张红彪 YANG Li;ZHANG Hong-biao

机构地区：[1]开封市第二中医院骨二科,河南开封475000

出　　处：《中国疗养医学》2024年第9期90-94,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的分析全髋关节置换手术患者康复效果的影响因素及与脂肪质量指数(FMI)的相关性。方法纳入开封市第二中医院2018年1月至2023年1月收治的全髋关节置换手术患者206例进行研究,所有患者均为单侧病变,回顾性分析患者的临床和随访资料,依据其术后3个月的Harris髋关节功能评分量表情况分为预后佳组(n=161)和预后差组(n=45),利用单因素和Logistic多因素分析全髋关节置换手术患者康复效果的影响因素,并经Pearson相关性分析明确FMI与全髋关节置换手术患者康复效果的相关性。结果预后差组患者的饮酒史、骨质疏松、肥胖占比高于预后佳组,差异有统计学意义(P<0.05)。预后差组患者的外科手术入路、手术时间>2 h、术中低血压、术中出汗、术中低体温、术中未实施疼痛管理、髋关节开始活动时间<3 d、术后蛛网膜下腔注射联合硬膜外自控镇痛、术后24 h NRS评分>3分、下肢静脉血栓占比高于预后佳组,预后差组患者隐性出血多于预后佳组,差异有统计学意义(P<0.05)。肥胖、髋关节开始活动时间<3 d、下肢静脉血栓、隐形出血量>250 mL为全髋关节置换手术患者康复效果差的危险因素(P<0.05)。Pearson相关性分析,FMI与全髋关节置换手术患者康复效果差呈现正相关(r=0.842,P=0.003)。结论肥胖、髋关节开始活动时间、下肢静脉血栓、隐形出血量为全髋关节置换手术患者康复效果差的危险因素,且FMI与全髋关节置换手术患者康复效果差呈正相关。Objective To analyze the influencing factors of rehabilitation outcomes in patients undergoing total hip replacement and their correlation with fat mass index(FMI).Methods A total of 206 patients who underwent total hip replacement in Kaifeng Second Traditional Chinese Medicine Hospital from January 2018 to January 2023 were recruited.All patients had unilateral lesions,and their clinical and follow-up data were retrospectively analyzed.Based on the Harris hip score at 3 months after surgery,patients were divided into the good prognosis group(n=161)and poor prognosis group(n=45).Univariate and multivariate logistic analyses were performed to determine the influencing factors of the rehabilitation outcome of patients undergoing total hip replacement.Pearson correlation analysis was used to clarify the correlation between FMI and the rehabilitation outcome of patients undergoing total hip replacement.Results The proportion of alcohol consumption,osteoporosis,and obesity in patients of the poor prognosis group was significantly higher than that of good prognosis group(P<0.05).The proportion of surgical approach,surgery time>2 hours,intraoperative hypotension,intraoperative sweating,intraoperative hypothermia,no pain management during surgery,hip joint mobilization time<3 days,postoperative subarachnoid injection combined with epidural self-control analgesia,postoperative numerical rating scale(NRS)score>3 points at 24 hours,and lower limb venous thrombosis was significantly higher in the poor prognosis group than that of the good prognosis group(P<0.05).The incidence of hidden bleeding was significantly higher in patients of the poor prognosis group than that of the good prognosis group(P<0.05).Obesity,hip joint activity time<3 days,lower limb venous thrombosis,and hidden bleeding>250 mL were risk factors for poor rehabilitation outcomes in patients undergoing total hip replacement(P<0.05).Pearson correlation analysis showed a positive correlation between FMI and poor rehabilitation outcomes in patients undergoing t

关 键 词：全髋关节置换手术 脂肪质量指数 康复效果 

分 类 号：R687.4[医药卫生—骨科学]