【作者】 刘栋华；

【导师】 黄枫；

【作者基本信息】 广州中医药大学 ， 中医学， 2011， 硕士

【摘要】 比较分析早期冰敷与蜡疗同时配合CPM活动锻炼对老年股骨转子间骨折患者的术后功能康复的影响,从而证实早期冰敷与蜡疗及CPM活动锻炼对骨折术后关节功能康复的作用,并进一步探讨老年股骨转子间骨折术后较佳的肢体功能恢复方法。方法：根据研究的筛选标准,选择于2010年9月至2011年4月在广州市中西医结合医院骨伤科住院治疗的股骨转子间骨折的老年患者23例为研究对象,对股骨转子间骨折患者行闭合复位PFNA内固定术后,早期分别行冰敷、蜡疗及CPM活动锻炼,根据入院或手术时间的先后随机分组,分为三组：A组(冰敷+蜡疗+CPM锻炼),B组(冰敷+CPM锻炼),C组(单纯CPM锻炼)通过术口出血量、患肢肿胀程度、VAS视觉疼痛评分、Harris评分等比较。综合各项指标,进行统计学分析,综合推导得出结论。结果：1、术后康复过程中,A组在术口出血量、肿胀值、疼痛度以及Harris评分中与B、C两组比较均有明显差异,能取得较好的效果(P<0.05,P<0.01,P<0.001)2、A组分别与B、C组比较术后患肢下地负重时间组间均有明显差异(P<0.05),而B组与C组比较则无明显差异(P>0.05)。结论：1、老年股骨转子间骨折术后早期使用术口冷敷的方法,可有效减少术口出血量以及在一定程度上使患者减轻痛楚并配合早期CPM锻炼及功能锻炼。2、配合蜡疗的使用能进一步减轻疼痛及使肿胀消退,结合CPM锻炼能更好、更快地恢复患肢的功能,从而达到疼痛少,下地早,减少并发症的治疗目的。更多还原

【Abstract】 Objective:To compare and analyze the influence of using the early cold compress and wax therapy to go with Continuous Passive Motion on the Joint functional rehabilitation in aged patients with intertrochanteric fracture after operation. To confirm the effect of the Joint functional rehabilitation in aged patients with fracture after operation by using the early cold compress and wax therapy to go with Continuous Passive Motion. And extremely approach the better methods of the Joint functional rehabilitation in aged patients with intertrochanteric fracture after operation.Methods:According to the selection criteria,23 cases of Senile intertrochanteric fractures, who plan to treat with PFNA(proximal femoral nail anti-rotation) in September 2010 to April 2011 from The Department of Orthopaedics, Integrated Traditional and Western Medicine Hospital, were randomly divided into three groups:In earlier period they were treated with the cold compress、the wax therapy and the CPM exercise. Group A (the cold compress、the wax therapy and the CPM exercise together), Group B(the cold compress and CPM exercise together), Group C(only the CPM exercise). And then compare and analyse the three groups of patients, the volume of blood from wound、the tumidity、the pain and the Harris score at different time. Synthesize the index to carry at the conclusion.Results:1. In postoperative rehabilitation course, group A is better than group B and C in the volume of blood from wound、the tumidity、the pain and the Harris score, and there are conspicuous disparity (P<0.05, P<0.01, P<0.001).2. Group A gets conspicuous disparity in the time of weight loading after operation by compare with group B and C difference (P<0.05). And there is not disparity to compare group B and group C (P>0.05)Conclusion:1. Using the cold compress on the wound of the senile patients with intertrochanteric fracture after operation, it can decrease volume of blood from the wound and lessen the pain.So that patients can carry out the early CPM exercise and functional exercise.2. Using the wax therapy can more lessen the pain and extinct the tumidity. It can make the functional rehabilitation recover better and more quickly, so that it can achieve the goals of treatmen that patients get less pain, activity earlier and decrease the complication.更多还原