目的 研究老年股骨转子间骨折(IFF)术前开始康复训练的治疗效果.方法 回顾性分析2014年1月-2016年10月该院接受闭合复位防旋股骨近端髓内钉内固定术手术治疗的老年IFF患者110例.根据患者是否术前接受康复训练分为术前训练组和对照组,两组术后康复训练计划相同.比较两组并发症的发生情况,入院、出院时疼痛评分(VAS),术后早期离床活动率,出院及术后3个月Barthel指数评分,住院天数和住院费用.结果 术前训练组术后并发症发生人数少于对照组,而术后早期离床活动率高于对照组(P<0.05);出院术前训练组VAS低于对照组(P<0.05),而Barthel指数评分高于对照组(P<0.05);住院天数有缩短,住院费用降低.患者出院后门诊随访3~6个月,失访7例.术前训练组术后3个月Barthel指数评分高于对照组(P<0.05).结论 老年IFF围手术期进行康复干预,物理治疗师术前开始对患者进行康复训练的效果优于术后开始康复训练.
Objective To study the effectiveness of preoperative rehabilitation in geriatric patients with intertrochanteric femoral fracture. Method Retrospective analysis was conducted on 110 geriatric patients with intertrochanteric femoral fracture from January 2014 to October 2016, who had PFNA surgery in theorthopaedics surgery ward of West China hospital, Sichuan university. Patients were divided into preoperative practice group and control group with the same postoperatively rehabilitative training program. Data of visual analogue scale(VAS), Barthel index, rate of post-operative ambulation within 7 days were analyzed by SPSS 19.0. Result All patients were followed-up from 3 to 6 months post-operation except 7 who were out of follow-up. Compared with control group, preoperative practice group had lower VAS score, higher early ambulation rate and higher Barthel index score. The differences were significant (P < 0.05). Meanwhile, the preoperative practice group had lower complication rate, shorter hospital stay and lower hospitalization expenses. Conclusion Rehabilitation throughout hospitalization is more efficient than post-operative rehabilitation on the geriatric intertrochanteric femoral fracture patients.