復(fù)雜肘關(guān)節(jié)骨折術(shù)后行早期綜合康復(fù)護(hù)理和延遲康復(fù)護(hù)理的效果對(duì)比

陳育珠++++++張素容

[摘要]目的 探討復(fù)雜肘關(guān)節(jié)骨折術(shù)后行早期綜合康復(fù)護(hù)理和延遲康復(fù)護(hù)理的效果對(duì)比。方法 選擇2014年12月～2016年7月在我院進(jìn)行復(fù)雜肘關(guān)節(jié)骨折手術(shù)的患者89例作為研究對(duì)象，根據(jù)其入院日期，單號(hào)日作為實(shí)驗(yàn)組，共44例，雙號(hào)日作為對(duì)照組，共45例。前者施以早期綜合康復(fù)護(hù)理，后者施以延遲康復(fù)護(hù)理。比較兩組患者康復(fù)護(hù)理前后的肘關(guān)節(jié)功能情況、康復(fù)治療效果及肘關(guān)節(jié)活動(dòng)表（ROM）評(píng)分情況。結(jié)果 干預(yù)后實(shí)驗(yàn)組患者的肘關(guān)節(jié)功能評(píng)分及Rom評(píng)分高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），干預(yù)前兩組患者肘關(guān)節(jié)功能評(píng)分及Rom評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。且實(shí)驗(yàn)組治療優(yōu)良率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 復(fù)雜肘關(guān)節(jié)骨折術(shù)后行早期綜合康復(fù)有利于其肘功能恢復(fù)，提高肘關(guān)節(jié)活動(dòng)度，值得推廣。

[關(guān)鍵詞]肘關(guān)節(jié)；骨折；早期綜合康復(fù)；延遲康復(fù)

[中圖分類號(hào)] R473.6 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2017）11（c）-0174-03

Comparison of early comprehensive rehabilitation and delayed rehabilitation nursing of complex elbow fractures

CHEN Yu-zhu ZHANG Su-rong

Department of Surgery，Puning Overseas Chinese Hospital，Guangdong Province，Puning 515300，China

[Abstract]Objective To investigate the effect of early comprehensive rehabilitation and delayed rehabilitation nursing after complex elbow fracture.Methods From December 2014 to July 2016，89 patients with complex elbow fractures were selected as the study subjects.According to their date of admission，single day as experimental group，44 cases double day as control group，a total of 45 cases.The former applied to the early comprehensive rehabilitation carethe latter to delay the rehabilitation of care.The elbow joint function，the rehabilitation effect and the elbow ROM score were compared between the two groups before and after rehabilitation.Results The elbow function score and Rom score of the experimental group were higher than those in the control group after intervention，the difference was statistically significant （P<0.05）.Before intervention，the difference of the elbow function score and Rom score between the two groups was no significant（P>0.05）.And the excellent rate of treatment in the experimental group was higher than that in the control group，the difference was statistically significant（P<0.05）.Conclusion The early comprehensive rehabilitation of complex elbow fractures is helpful for the recovery of elbow function and the improvement of elbow joint activity.

[Key words]Elbow joint fracture；Early comprehensive rehabilitation；Delayed rehabilitation

肘關(guān)節(jié)是人體重要的上肢關(guān)節(jié)，主要用于前臂伸屈活動(dòng)及旋轉(zhuǎn)運(yùn)動(dòng)等[1]。由于其生理結(jié)構(gòu)，其骨折發(fā)生率為骨關(guān)節(jié)骨折之首[2]。目前臨床上主要對(duì)其采取手術(shù)治療[3]，但由于肘關(guān)節(jié)骨質(zhì)重疊較多等因素，且肘關(guān)節(jié)骨折不穩(wěn)定，特別是在康復(fù)期不恰當(dāng)?shù)母深A(yù)更易引起肘關(guān)節(jié)的功能異常，影響其預(yù)后[4]。傳統(tǒng)的康復(fù)護(hù)理干預(yù)一般于術(shù)后3個(gè)月取下外固定后進(jìn)行，本研究為使復(fù)雜肘關(guān)節(jié)骨折術(shù)后患者達(dá)到更好的治療效果及康復(fù)，將早期綜合康復(fù)護(hù)理及延遲康復(fù)護(hù)理分別運(yùn)用于復(fù)雜肘關(guān)節(jié)骨折手術(shù)的患者中，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選擇2014年12月～2016年7月在我院進(jìn)行復(fù)雜肘關(guān)節(jié)骨折手術(shù)的患者89例作為研究對(duì)象，根據(jù)入院日期，單號(hào)日作為實(shí)驗(yàn)組，44例，雙號(hào)日作為對(duì)照組，45例。前者施以早期綜合康復(fù)護(hù)理，后者施以延遲康復(fù)護(hù)理。所有患者均知情同意，且本研究經(jīng)醫(yī)院醫(yī)學(xué)倫理委員會(huì)批準(zhǔn)。納入標(biāo)準(zhǔn)已排除合并嚴(yán)重內(nèi)科合并癥、嚴(yán)重心肺肝腎功能障礙患者。實(shí)驗(yàn)組男30例，女14例；年齡19～66歲，平均（42.98±1.34）歲；肱骨踝間骨折16例，肱骨踝上骨折13例，肱骨小頭骨折9例，尺骨鷹嘴骨折4例，尺骨冠突骨折2例。對(duì)照組男28例，女17例；年齡21～64歲，平均（44.10±1.02）歲；肱骨踝間骨折15例，肱骨踝上骨折16例，肱骨小頭骨折7例，尺骨鷹嘴骨折5例，尺骨冠突骨折2例。兩組患者一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。endprint