康复指导对老年股骨颈骨折患者术后功能恢复的疗效评价

摘要

目的：探讨功能锻炼结合心理支持等康复指导对老年股骨颈骨折术后肢体功能的康复效果。方法选择广元市剑阁县中医院骨科2011年1月至2013年1月收治的74名股骨颈骨折患者为研究对象，随机分为干预组和对照组各37例，干预组给予功能锻炼结合信息支持、情感支持、人际支持等一系列康复指导，对照组给予常规护理结合功能锻炼，分别于患者出院当日和出院3个月时评价 Harris 髋关节评分、疼痛评分、关节活动度评分等。结果干预组患者出院时 Harris 髋关节总评分为（38．76±6．67）分，对照组为（36．55±5．34）分，两组比较差异无统计学意义（P＞0．05）；而在出院后3个月干预组为（73．75±9．04）分，对照组为（65．19±7．67）分，两组患者评分明显高于出院时，且干预组评分明显高于对照组患者，差异均有统计学意义（P ＜0．05）。干预组疼痛评分、关节活动度评分在出院时略高于对照组，出院后3个月时两组疼痛评分、关节活动度评分差异更加明显，差异有统计学意义（P＜0．05）；两组患者出院时髋关节畸形评分与功能评分相近（P＞0．05），出院3个月后干预组功能得分明显高于对照组，差异有统计学意义（P＜0．05）。结论功能锻炼结合信息支持、情感支持、人际支持等一系列康复指导，可有效改善老年股骨颈骨折患者术后髋关节功能，减轻术后疼痛，提高髋关节活动度，促进患者术后身心康复。%Objective To explore the efficacy of functional exercise combined with psychological support measures for functional recovery of elderly patients with femoral neck fracture .Methods A total of 74 elderly pa-tients with femoral neck fractures were selected and randomly divided into intervention group and control group ,each group with 37 cases ,the intervention group was given function training and information support ,emotional support , interpersonal support and a series of rehabilitation ,the control group was given routine nursing care and functional exercise ,Harris hip score were noted and compared between the two groups on the day discharged from hospital and 3 months later respectively .Results On the day discharged from hospital ,Harris hip average score of patients in the intervention and control group was (38 .76 ± 6 .67) and (36 .55 ± 5 .34) respectively ,and there was no significant difference between the two groups(P> 0 .05) .After 3 months ,Harris hip average score of patients in the intervention group and the control group were (73 .75 ± 9 .04)and(65 .19 ± 7 .67)respectively ,which were all significant higher than those of the day when discharged from hospital (P< 0 .05) ,and the score of the intervention group was signifi-cant higher than that of the control group(P< 0 .05) .The differences of the two groups on the pain score ,joint activi-ty score ,function score and hip joint deformity score were slightly on the day when discharged from hospital ,but the first three score were with significant differences after three months ( P < 0 .05 ) .Conclusion Functional exercise combined with psychological support and a series of rehabilitation guidance could effectively improve the hip joint function for elderly patients with femoral neck fracture ,reduce postoperative pain ,and promote the rehabilitation of patients after operation .