摘要
目的 术前应用可调矫形鞋结合站立位双下肢全长X线片测量单侧CroweⅣ型髋关节发育不良患者术中截骨长度,探讨其可行性及效果.方法 2013年1月至2014年6月,对18例单侧CroweⅣ型髋关节发育不良患者行全髋关节置换术,男6例,女12例,年龄（47.5±3.1）岁.术前予患者拍双下肢全长正位X线片,评估患者腰骶部疼痛数字评分（NRS）、日常生活能力量表（ADL）评分.责任护士给予全面的健康宣教、功能锻炼的指导、详细指导患者正确穿戴可调矫形鞋行走,至患者主观感受双下肢等长、行走平衡1个月.根据其矫形鞋的调整高度,结合站立位双下肢全长X线片,计算术中需要截骨长度.术后随访（2.7±0.2）年,末次随访时评估其腰骶部疼痛NRS评分及ADL日常生活评分.结果 至末次随访时,患者行走步态正常,患者腰骶部疼痛NRS评分、ADL评分及在躯体生活自理维度得分、工具性日常生活能力维度得分分别为（3.1±0.6）、（76.2±4.7）、（18.2±8.2）、（44.8±6.1）分,术前分别为（8.7±0.3）、（43.3±9.5）、（18.2±8.2）、（25.1±9.8）分,应用可调矫形鞋前后比较差异有统计学意义（t=6.25～35.41,均P〈0.01）.结论 用可调矫形鞋术前可精确测量术中截骨长度,优化手术步骤.术后患者步态改善明显,临床疗效满意.
Objective To investigate the feasibility and results of unilateral Crowel Ⅳdevelopmental dyspepsia of the hip（DDH）length of bone shortened in operation by using adjustable orthopedics and measuring the double leg length X-ray PA at erect position before operation. Methods Totally 18 unilateral Crowel Ⅳ DDH patients underwent total hip replacement（THR）between January 2013 and June 2014, there were 6 male and 12 female patients with a mean age of （47.5 ± 3.1） years old. Before operation, the double leg length X-ray PA was measured, lumbosacral portion pain by Numeric Rating Scale（NRS）and activities of daily living（ADL） were assessed. The responsible nurses provide comprehensive health education and instruction on functional exercises, instruct patients to wear adjustable orthopedics to walk until they felt two legs were equilong and a balanced walking for one month. With the orthopedics＇adjustable height and the double leg length X-ray PA at erect position, calculating the length of bone shortened in operation. Postoperative follow-up was carried out for （2.7±0.2） years, the lumbosacral portion pain was assessed by NRS and ADL at last follow-up. Results On the last follow-up, there was a normal gait, the lumbosacral portion pain assessed by NRS, ADL score, score of physical self-maintenance dimension, score of instrumental activities of daily living dimension were 3.1±0.6, 76.2± 4.7, 18.2 ± 8.2, 44.8 ± 6.1, and were 8.7 ± 0.3, 43.3 ± 9.5, 31.4 ± 3.6, 25.1 ± 9.8 before operation, there were statistic differences between them （t=6.25-35.41, P〈0.01）. Conclusions Using adjustable orthopedics before operation can calculate exactly the length of bone shortened in operation, simplify the operation process. After operation, there is obvious gait improvement and satisfying clinical effect.
出处
《中国实用护理杂志》
2017年第34期2697-2700,共4页
Chinese Journal of Practical Nursing
关键词
可调矫形鞋
髋关节发育不良
关节置换
截骨长度
Adjustable orthopedics
Developmental dyspepsia of the hip
Arthroplasty
Length of bone shortened
