围手术期康复宣教与训练对股骨干骨折患者的影响

【】　目的　探讨康复宣教与训练等干预手段对股骨干骨折患者围手术期的影响。　方法　2010年6月－2011年3月收治股骨干骨折患者90例，其中男48例，女42例；年龄17~58岁，平均38岁。开放性骨折28例，闭合性骨折62例。股骨骨折部位上1/3骨折33例，中1/3骨折35例，下1/3骨折20例，多段骨折2例。横形骨折20例，斜形骨折30例，粉碎性骨折40例。将90例患者随机分为康复组（46例）和对照组（44例）。对照组采用骨科术前常规处理，康复组采用骨科术前常规处理加康复宣教与训练。　结果　康复组住院时间为（5.35±1.27）d，对照组为（7.67±1.85）d，两组比较差异有统计学意义（P<0.05）。康复组治疗后发生并发症7例，对照组16例，康复组并发症发生率（15.2%）明显低于对照组（36.4%），差异有统计学意义（P<0.05）。治疗后5d，康复组疗效获优35例，良6例，可3例，差2例，优良率89.1%；对照组获优25例，良5例，可12例，差2例，优良率68.2%；两组疗效比较差异有统计学意义（P<0.05）。　结论　康复宣教与训练能预防与改善股骨干骨折围手术期卧床引起的并发症，减轻患者腿部疼痛及肿胀，缩短围手术期时间，使患者能尽早手术，加快住院床位周转，提高患者生活质量。【Abstract】　Objective　Toexploretheeffectsofrehabilitationeducationandtraininginterventionsonperioperativepatientswithfemoralshaftfractures.　Methods　Atotalof90patientswithfemoralshaftfractureswereselectedfromJune2010toMarch2011,including48malesand42femalesagedfrom17to58years(mean38years).Inthese90patients,openfracturewasin28andclosedfracturewasin62.Fracturesiteupper1/3fracturewasin33,middle1/3fracturewasin35,lower1/3fracturewasin20andmultiplefractureswasin2.Thereweretransversefracturesin20patients,obliquefracturesin30patientsandcomminutedfracturesin40patients.Allofthepatientswererandomlydividedintoexperimentalgroup(46patients)andcontrolgroup(44patients).Thepatientsinthecontrolgroupunderwenttheroutinetreatmentbeforetheorthopedicsurgery;besidestheroutinetreatment,thepatientsintheexperimentalgroupweregiventherehabilitationeducationandtrainingbeforetheorthopedicsurgery.　Results　Thehospitaldurationintherehabilitationgroupwas(5.35±1.27)dayswhileinthecontrolgroupwas(7.67±1.85)days,thedifferencewasstatisticallysignificant(P<0.05).Therewere7caseswhohadcomplicationsinrehabilitationgroupcomparedwith16patientsinthecontrolgroup;theincidenceofthecomplicationsintherehabilitationgroup(15.2%)wassignificantlylowerthanthatinthecontrolgroup(36.4%)(P<0.05).Afterthetreatmentfor5days,thetherapeuticeffectinrehabilitationgroupwereexcellentin35cases,goodin6cases,middlein3casesandpoorin2cases(withthegoodrateof89.1%);whileinthecontrolgroupwereexcellentin25cases,goodin5cases,middlein12casesandpoorin2cases(withthegoodrateof68.2%);thedifferencewassignificantbetweenthetwogroups(P<0.05).　Conclusion　Rehabilitationeducationandtrainingcouldpreventtheperioperativecomplicationsinpatientswithfemoralshaftfracture,decreasethepainandedema,speeduptheturnoverofhospitalbeds,andimprovethepatients’qualityoflife.