中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4086-4089.doi: 10.3969/j.issn.1673-8225.2010.22.024

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

髋关节假体置换与临床康复治疗

龙  晖   

  1. 吴川市人民医院康复科，广东省吴川市  524500
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:龙 晖，女，1968年生，广东省吴川市人，汉族，2007年广东医学院毕业，主治医师，科主任，主要从事康复、理疗、针灸诊断与治疗等方向研究。 L15812368798@163.com

Hip prosthesis replacement and clinical rehabilitation treatment

Long Hui   

  1. Rehabilitation, Wuchuan People’s Hospital, Wuchuan  524500, Guangdong Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Long Hui, Attending physician, Department of Rehabilitation, Wuchuan People’s Hospital, Wuchuan 524500, Guangdong Province, China L15812368798@163.com

PDF

398

被引次数

19

摘要：

目的：探讨髋关节假体置换后整体康复治疗功能训练的方法和效果。
方法：由作者应用计算机检索1990/2008 PubMed数据(http://www.ncbi.nlm.nih.gov/PubMed)及万方数据库(http://www.wanfangdata.com.cn)有关髋关节假体置换及髋关节置换后康复治疗方面的文献，英文检索词为“artificial，replacement，rehabilitation  kinesiatrics，hip joint prosthesis”，中文检索词为“人工髋关节假体，置换，康复训练”。排除重复性研究。
结果：髋关节假体置换后康复治疗的目的，在于缓解髋关节疼痛，矫正髋关节畸形，改善髋关节功能状态，从而提高患者的生活质量。早期持续、有针对性的康复训练，可减少术后并发症，加速髋关节功能康复，缩短住院治疗时间。假体植入后康复训练与负重有着明显的时期差异，应依据假体特性设计不同的康复程序。康复训练在3个月内应注意休息，愈合后开始康复训练活动过程中不应引起患者的剧烈疼痛。检索资料结果显示，手术及整体康复治疗能很大程度地改善髋关节功能，减少不适症状。还要掌握不同时期患者的心理状态，坚持循序渐进；术后要做到由轻到重，由易到难，由被动到主动运动锻炼，训练强度以患者接受为宜，康复治疗中应避免发生损伤，髋假体置换后被动屈曲练习等应在康复治疗师指导下进行，以防发生股四头肌腱部分断裂；术后2周内关节活动度训练尤为重要，能最大限度改善髋关节功能。
结论：置换后早期的功能锻炼应遵循人文关怀理念，循序渐进、主动与被动相结合的原则，康复锻炼的程序为肌肉舒缩运动、关节屈伸-离床战立-借助支持物行走-徒步行走。

关键词: 康复, 功能训练, 组织工程, 髋关节假体置换, 人工假体

Abstract:

OBJECTIVE: To explore the method and effect of rehabilitative functional training following hip replacement.
METHODS: A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) was performed for articles regarding hip joint prosthesis replacement and rehabilitative treatment following hip replacement, with the key words “artificial, replacement, rehabilitation, hinesiatrics, hip joint prosthesis” in English and “artificial hip joint prosthesis, replacement, rehabilitation training” in Chinese. Repetitive studies were excluded.
RESULTS: The rehabilitation following hip replacement is to relieve hip pain, correct hip deformity, improve hip functional status and better quality of life. Early continuous, directional rehabilitation training can reduce postoperative complications, accelerate hip functional restoration and shorten hospital stay. There are significant period differences between rehabilitation training and weight loading following prosthesis implantation, which should be performed according to prosthesis designs. Rest is important in the first 3 months of rehabilitation training to prevent severe pain. Retrieved data show that operation and rehabilitation treatment greatly improved hip function and reduced complications. In addition, the mental state of patients at different stages, degree and intensity of training should be paid attention. It is necessary to prevent injury during rehabilitation treatment. Therefore, the passive flexion exercise should be performed under the guidance of rehabilitation therapist to prevent tendon breakage of quadriceps femoris. The range of motion at 2 weeks postoperatively is the most important, which may maximize hip prosthesis function improvement.
CONCLUSION: Early functional exercise following replacement should be performed step by step, from passive to active. The process is muscle stretch and contraction, joint flexion and extension, standing out of bed, assisted walking and independent walking.

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