《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (4): 491-496.doi: 10.3969/j.issn.1006-9771.2023.04.016
• 应用研究 • 上一篇
收稿日期:
2022-10-08
修回日期:
2023-02-01
出版日期:
2023-04-25
发布日期:
2023-05-19
通讯作者:
吴鸣,E-mail: 作者简介:
赵婧(1990-),女,汉族,安徽蒙城县人,硕士,治疗师,主要研究方向:肌肉骨骼康复、作业治疗。
基金资助:
ZHAO Jing, WU Ming(), NI Chaomin, ZHANG Yang, CUI Juncai
Received:
2022-10-08
Revised:
2023-02-01
Published:
2023-04-25
Online:
2023-05-19
Contact:
WU Ming, E-mail: Supported by:
摘要:
目的 观察作业治疗在全膝关节置换术围手术期介入的早中期临床效果。
方法 2018年7月至8月,中国科学技术大学附属第一医院行初次全膝关节置换术患者100例,根据治疗方案分为对照组(n = 50)和观察组(n = 50)。两组均接受常规术前康复教育、手术治疗及术后物理治疗,观察组额外进行围手术期作业治疗。分别在术前,术后1 d、2 d、3 d,出院当天,术后1个月、3个月和6个月采用改良Barthel指数(MBI)和工具性日常生活活动量表(IADL)进行评定。
结果 术后1 d、2 d、1个月、3个月、6个月,观察组MBI评分均高于对照组(t > 2.113, P < 0.05)。术后1个月和3个月,观察组IADL评分显著高于对照组(t > 5.125, P < 0.001)。观察组术后住院天数显著少于对照组(t = -5.356, P < 0.001),治疗费用低于对照组(t = -2.455, P < 0.05)。
结论 作业治疗能有效改善全膝关节置换术患者早中期日常生活活动能力,早日回归正常生活。
中图分类号:
赵婧, 吴鸣, 倪朝民, 张阳, 崔俊才. 全膝关节置换术围手术期作业治疗的效果[J]. 《中国康复理论与实践》, 2023, 29(4): 491-496.
ZHAO Jing, WU Ming, NI Chaomin, ZHANG Yang, CUI Juncai. Effect of perioperative occupational therapy on patients after total knee arthroplasty[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 491-496.
表2
两组MBI评分比较"
组别 | n | 术前 | 出院当天 | 术后1 d | 术后2 d | 术后3 d | 术后1个月 | 术后3个月 | 术后6个月 |
---|---|---|---|---|---|---|---|---|---|
对照组 | 50 | 94.68±6.21 | 74.60±12.50 | 49.36±15.90 | 62.96±15.94 | 68.94±14.10 | 88.94±6.48 | 92.52±5.44 | 95.42±3.99 |
观察组 | 50 | 94.00±9.26 | 77.44±10.26 | 59.98±15.70 | 68.92±11.73 | 73.06±9.52 | 93.94±4.76 | 94.48±3.67 | 97.80±1.41 |
t值 | -0.431 | 1.242 | 3.362 | 2.130 | 1.712 | 4.396 | 2.113 | 3.975 | |
P值 | 0.667 | 0.217 | 0.001 | 0.036 | 0.090 | < 0.001 | 0.037 | < 0.001 |
表3
两组MBI有关指标评分比较"
组别 | 对照组 (n = 50) | 观察组 (n = 50) | Z值 | P值 | 组别 | 对照组 (n = 50) | 观察组 (n = 50) | Z值 | P值 |
---|---|---|---|---|---|---|---|---|---|
术前 | 术后3 d | ||||||||
床椅转移 | 15(15, 15) | 15(15, 15) | 0.400 | 0.997 | 床椅转移 | 12(8, 12) | 12(11, 15) | 0.400 | 0.997 |
如厕 | 10(10, 10) | 10(10, 10) | 0.100 | 1.000 | 如厕 | 8(5, 8) | 8(8, 8) | 0.700 | 0.711 |
平地行走45 m | 15(12, 15) | 15(15, 15) | 0.600 | 0.864 | 平地行走45 m | 12(8, 12) | 12(12, 12) | 0.800 | 0.544 |
上下楼梯 | 8(0, 8) | 8(0, 10) | 0.600 | 0.864 | 术后1个月 | ||||
出院当天 | 床椅转移 | 12(12, 15) | 15(15, 15) | 1.500 | 0.022 | ||||
床椅转移 | 12(12, 15) | 12(12, 15) | 0.400 | 0.997 | 如厕 | 9(8, 10) | 10(10, 10) | 2.500 | < 0.001 |
如厕 | 8(8, 8) | 8(8, 8) | 0.500 | 0.964 | 平地行走45 m | 12(12, 12) | 12(12, 15) | 0.300 | 1.000 |
平地行走45 m | 12(12, 12) | 12(12, 12) | 0.300 | 1.000 | 上下楼梯 | 5(0, 8) | 8(3.75, 8) | 1.900 | 0.001 |
上下楼梯 | 0(0, 0) | 0(0, 0) | 0.100 | 1.000 | 术后3个月 | ||||
术后1 d | 床椅转移 | 15(15, 15) | 15(15, 15) | 0.400 | 0.997 | ||||
床椅转移 | 0(0, 12) | 8(8, 12) | 1.900 | 0.001 | 如厕 | 10(10, 10) | 10(10, 10) | 1.000 | 0.270 |
如厕 | 0(0, 5.75) | 8(0, 8) | 2.100 | < 0.001 | 平地行走45 m | 12(12, 15) | 15(12, 15) | 2.000 | 0.001 |
平地行走45 m | 0(0, 8) | 8(2.25, 12) | 2.100 | < 0.001 | 上下楼梯 | 5(0, 8) | 8(7.25, 8) | 1.500 | 0.022 |
术后2 d | 术后6个月 | ||||||||
床椅转移 | 12(6, 12) | 12(8, 12) | 0.800 | 0.544 | 床椅转移 | 15(15, 15) | 15(15, 15) | < 0.001 | 1.000 |
如厕 | 8(0, 8) | 8(5, 8) | 0.800 | 0.544 | 如厕 | 10(10, 10) | 10(10, 10) | 0.100 | 1.000 |
平地行走45 m | 8(0, 12) | 12(8, 12) | 1.100 | 0.178 | 平地行走45 m | 15(15, 15) | 15(15, 15) | 0.100 | 1.000 |
上下楼梯 | 8(0, 8) | 8(8, 8) | 1.700 | 0.006 |
表5
两组IADL有关指标评分比较"
组别 | 对照组(n = 50) | 观察组(n = 50) | Z值 | P值 |
---|---|---|---|---|
术前 | ||||
购物 | 1.5(0, 3) | 2.5(0, 3) | 0.400 | 0.997 |
外出 | 1(0.75, 3) | 3(1, 4) | 1.300 | 0.068 |
烹饪 | 3(1, 3) | 3(3, 3) | 0.500 | 0.964 |
家务 | 3(3, 3) | 3(3, 3) | 0.300 | 1.000 |
术后1个月 | ||||
购物 | 1(0, 2) | 2(2, 2) | 2.000 | 0.001 |
外出 | 1(0, 3) | 3(3, 4) | 2.100 | 0.000 |
烹饪 | 2(0, 3) | 3(3, 3) | 2.400 | < 0.001 |
家务 | 2(0, 3) | 3(3, 3) | 2.100 | < 0.001 |
术后3个月 | ||||
购物 | 1.5(0, 2) | 2(2, 3) | 2.100 | < 0.001 |
外出 | 1(0, 3) | 3(3, 4) | 2.800 | < 0.001 |
烹饪 | 2(1, 3) | 3(3, 3) | 1.800 | 0.003 |
家务 | 3(1, 3) | 3(3, 3) | 1.700 | 0.006 |
术后6个月 | ||||
购物 | 3(1, 3) | 3(3, 3) | 2.000 | 0.001 |
外出 | 2.5(1, 4) | 1(3, 4) | 0.600 | 0.864 |
烹饪 | 3(2.75, 3) | 3(3, 3) | 0.900 | 0.393 |
家务 | 3(3, 3) | 3(3, 3) | 0.900 | 0.393 |
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