儿童发育性髋关节脱位术后关节序贯性康复训练疗效观察.docVIP

儿童发育性髋关节脱位术后关节序贯性康复训练疗效观察 【摘要】目的探讨儿童发育性髋关节脱位术后康复训练的重要性及寻找最佳训练方法。方法选择56例发育性髋关节脱位患儿，入院后行骨盆截骨(Salter)术，36例患儿术后当天护理人员即开始进行康复训练和心理康复治疗，根据伤口愈合及患儿髋关节功能恢复情况，术后不同时间采用不同的训练方法，物理疗法、主动运动、被动运动和持续被动运动相结合；20例患儿按传统的方法由其家属协助进行髋关节训练。结果Harris 评分经过序贯训练的康复组患儿术后的髋关节明显优于一般锻炼的对照组（P0.05）。 结论儿童发育性髋关节脱位术后早期关节序贯性康复训练，可以提高发育性髋关节脱位患儿的手术疗效，最大限度地恢复关节功能，减少并发症，提高生存质量。 【关键词】 髋关节脱位；儿童；康复训练 Child developmental dislocation of the hip (DDH) joint after sequential rehabilitation training MA Yuhua （Taian City Central Hospital, Taian 271000, China） Abstract:Objective: To explore the importance and the best methods of rehabilitation after operation for developmental dislocation of the hip (DDH) in children. Methods: Fifty-six cases treated with pelvis osteotomy operation were divided into 2 groups. Thirty-six cases in group 1 were treated with exercise rehabilitation and psychological treatment immediately after the operation. Based on the recovery of the hip fuction, physiotherapy, active exercise, passive exercise or endurance physical therapy were manipulated. The other 20 cases in group 2 were treated with traditional manual therapy with the help of the family members. Results: According to Harris score, group 1 （treated with Sequential training ）acquired better curative effect than group 2（treated with traditional manual therapy）. Conclusion: Rehabilitation after operation for DDH is helpful in improving the operation effect, maximizing the hip function, decreasing the complications and upgrading the life quality. Key words:developmental dislocation of the hip; children; rehabilitation 儿童发育性髋关节脱位（Developmental dislocation of the hip，DDH）是导致儿童肢体残疾的主要疾病之一，术后并发髋关节活动受限或僵硬较为常见，特别是术后用髋人字石膏固定者更易发生［1］。近年来，对发育性髋关节脱位术后的患儿进行了序贯康复训练，使患儿术后髋关节功能恢复良好，报告如下。 1 资料与方法 1.1 临床资料 2002～2007年56例发育性髋关节脱位患儿，均行Salter骨盆截骨手术，部分同时行股骨近端旋转截骨。其中男性10例，女性46例，年龄最小2岁，最大7岁，平均4岁1个月。其中36例行序贯性康复训练，为康复组；20例行一般康复训练，作为对照组。术后4周去除石膏外固定。 1.2 髋关节康复指导 康复序贯性训练是护士及其家属对发育性髋关节脱位术后患儿按照一定顺序进行的一系列功能训练的方法和步骤，包括以下 1.2.1 外固定期功能训练 术后1 d～4 w。此期主要是石膏内