老年患者全髋关节置换术后早期关节脱位原因分析及对策*

摘要

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.%目的：了解老年患者全髋关节置换术后早期关节脱位的原因并提出对策。方法回顾性总结168例行人工全髋关节置换术的老年患者的一般资料，对发生早期关节脱位患者的发生关节脱位类型和原因及发生时间进行归纳和分析。结果168例患者中有7例（4．1％）发生早期关节脱位，均为I类脱位，男2例，女5例，年龄65～89岁，发生时间为术后4～5周。发生原因为床上排尿时过度屈髋、睡眠中翻身屈髋内收内旋、搬运过程中用力过度致后脱位、下地行走活动弯腰过度屈髋、排便时过度屈髋屈膝。结论老年患者全髋关节置换术后发生关节均为I类脱位，发生时间为术后4～5周，女性患者比男性患者比例大；主要原因是运动不当或活动范围过大。护理重点是早期采取有效的预防措施及正规的康复训练计划，加强心理支持，重视安全护理。