摘要
目的探讨个体化康复训练对老年髋部骨折病人术后恢复的影响。方法以2018年2月—2021年1月在株洲市人民医院进行治疗的120例老年髋部骨折术后病人作为研究对象,使用随机数字表法分为对照组和观察组,每组60例。对照组采取常规康复方法训练,观察组实施个体化阶段性训练方案。比较两组围术期相关指标、骨折治疗后功能恢复效果、日常生活活动能力、肌力变化、骨代谢指标之间的差异。结果两组手术时间、术中出血量、术后引流量、手术切口长度等比较差异无统计学意义(P>0.05)。观察组病人的骨折治疗后功能恢复效果优于对照组(χ^(2)=9.412,P<0.05)。观察组病人日常生活活动能力自评量表(ADL)评分显著高于对照组,两组病人的峰力矩(PT)、平均功率(AP)显著升高,且观察组病人的PT、AP显著高于对照组,差异均有统计学意义(t=4.890~16.626,P<0.05)。两组病人碱性磷酸酶(ALP)、骨钙素(BGP)均显著下降,血清护骨素(OPG)、分泌蛋白dickkopf-1(DKK-1)显著上升,且观察组病人的ALP、BGP显著低于对照组,OPG、DKK-1显著高于对照组,差异均有统计学意义(t=6.105~230.013,P<0.05)。结论老年骨折病人采取个体化康复训练方案,可显著改善其功能恢复及骨代谢标志物,建议临床推广应用。
Objective To investigate the effect of individual rehabilitation training on the postoperative recovery of elderly patients with hip fractures.Methods A total of 120 elderly patients with hip fractures who underwent surgery in Zhuzhou People’s Hospital from February 2018 to January 2021 were enrolled as subjects,and they were divided into control group and observation group using a random number table,with 60 patients in each group.The patients in the control group received routine rehabilitation training,and those in the observation group received individualized staged training program.The two groups were compared in terms of perioperative indicators,functional recovery after treatment,Activities of Daily Living,muscle strength,and bone metabolic markers.Results There were no significant differences between the two groups in time of operation,intraoperative blood loss,postoperative drainage volume,and length of surgical incision(P>0.05).The observation group had significantly better functional recovery than the control group after treatment(χ^(2)=9.412,P<0.05).The observation group had a significantly higher score of Activities of Daily Living than the control group;both groups had significant increases in peak torque(PT)and average power(AP),and the observation group had significantly higher PT and AP than the control group(t=4.890-16.626,P<0.05).Both groups had significant reductions in alkaline phosphatase(ALP)and osteocalcin(BGP)and significant increases in serum osteoprotegerin(OPG)and the secretory protein DKK-1,and compared with the control group,the observation group had significantly lower ALP and BGP and significantly higher OPG and DKK-1(t=6.105-230.013,P<0.05).Conclusion Indivi-dualized rehabilitation training program for elderly patients with fractures can significantly improve their functional recovery and bone metabolic markers,and therefore,it holds promise for clinical application.
作者
毛瑜芳
李康华
朱彬
龙江
MAO Yufang;LI Kanghua;ZHU Bin;LONG Jiang(Department of Sports Medicine,Zhuzhou People’s Hospital,Changsha Medical University,Zhuzhou 412000,China)
出处
《青岛大学学报（医学版）》
CAS
2023年第4期572-575,共4页
Journal of Qingdao University(Medical Sciences)
基金
湖南省自然科学基金省市联合基金项目(2021JJ-50064)。
关键词
股骨骨折
老年人
运动疗法
功能恢复
治疗结果
femoral fractures
aged
exercise therapy
recovery of function
treatment outcome
