老年骨折患者的康复指导

Backgroud：Forthefunctionofimportantorgansdecreasesintheaged，atthesametimemanychronicdiseasesandosteoporosisoftenco－exist，thefractureofoldpeopleisn＇teasytoheal．Theusageofrehabilitationtrainingwhichfitsfortheagedreducedtheincidenceofdisability．Objective：Todirecttherehabilitationoftheaged．Unit：CentralHospitalofPanzhihua．Subjects：２０４oldpatientswithfracturereceivedfromJanuary１９９９toOctober２００１，１０８malesand９６females，agedfrom６０to９０withthemeanageof７５．Inthem７８wi…     

骨折病人的康复治疗

目的 探讨骨折病人康复治疗的有效方法.方法 对116例骨折病人经骨折内固定及外固定治疗后,开始功能锻炼、饮食调理及健康指导.结果 11例下肢骨折病人拆除外固定时有轻度关节僵直、水肿,经温泉泡浴结合锻炼理疗后水肿消失,关节活动恢复正常范围;1例漂浮膝骨折经手术内固定治疗后,下床负重锻炼时膝关节僵直,经锻炼理疗2周后好转;其他病人均正常愈合,无肌肉萎缩、骨质疏松、肌健挛缩及关节僵直等并发症的发生.结论 骨折病人经康复治疗,能有效促进骨折的愈合及功能恢复,减少病残.     

老年髋关节置换术患者的康复训练

目的总结老年髋关节置换术后实施康复训练的效果。方法101例老年髋关节置换术后，从第1天开始，依据髋关节训练程序进行系统的练习。采用Harris评分对康复患者进行测评。结果康复优良率达91％。结论老年髋关节置换术后进行循序渐进的康复训练，康复快，恢复效果好，并发症少。     

老年股骨干骨折的康复护理

股骨干骨折多发于年龄较高的人群,患者常伴有多种老年病,治疗难度较大.以往对骨关节的康复重视不够,常发生关节僵硬、骨质疏松、废用性肌萎缩等骨折瘠~([1]).为了探讨康复护理在股骨干骨折术后的应用效果,2008年以来,本研究对98例老年股骨干骨折患者施行了针对性的康复护理,取得良好的效果,现报道如下.     

外伤性骨折患者家庭康复指导

Background:Aftercriticalstage,patientswithtraumaticfracturemayrestathomeandmostrehabilitationexerciseswillbetakenunderhelpoffamilies.Butpatientsareoftentakencareofblindlyandrandomlyduetofamilies'lackingofnursingacknowl-edgeandskills.Objective:Toexploretheeffectsoffamilyrehabilitationin-structiononpatientswithtraumaticfracture.Unit:People'sHospitalofJiaonanCitySubjects:101casesoffracturesoflimbswereinvestigated,including76males,25females,aged5-67(mean:45)yearsold,amongwhichwere59fracturesofu…     

Rehabilitation instruction to families of patients with traumatic fracture

Backgroung:After critical stage,patients with traumatic fracture may rest at home and most rehabilitation exercieses will be taken under help of families,But patients are often taken care of blindly and randomly due to families‘ lacking of nursing acknowledge and skills.OJbjective:To explore the effects of family rehabilitation instruction on patients with traumatic fracture.Unit:People‘s Hospital of Jaonan City Subjects:101 cases of fractures of limbs were investigated,including 76 males,25 females,aged 5-67(mean:45)years old,among which were 59 fractures of upper limbs,31 fracures of lower limbh and 11 fractures of bot limbs.Intervention:Nursing instruction:(1)Patients in bed should eat vegetables sabundant of vitamin,banana,honey to promote defecation,catharsis drugs were used if necessary.Enough drinking and diuresis were adopted to prevent infection and calculi of urinary system.(2)To patients using plater,plaster should be kept clean.If found dirty,it must be cleaned with toweling with soap and clean water.But softening of plaster should be avoided and contamination by urine and stool should be paid attention to.Rolling were adopted when turning over preventing angled compression on join.When itching appeared,scratching should be inhibited,alcohol was adpted when necessary.(3)Rubbing bath was adopted,once a day,often changing of underwear,loose clother and trousers.(4)Patients rested on plant bed with middle-thick mat and affected limbs were elevated.Instuction of opportunity and methods:(1)Early stage:within 2 weeks,active contracting and relaxing should be taken to promote reflux of deep veins and swelling.(2)Intermediate stage:3-6 weeks after fracture,movement of joints was taken at some adopted when callus began to grow and ripe.(3)Late stage:exopexy was removed when fracture got from.and comprechensive muscle and joint exercises were taken until complete recovery.Nursing process was rowked out,compiled and handed out to families when leaving hospital.Results:After 2-3 months of follow-up survery,no articular stiffness,spasm of muscle,bed sore and infection of urinary system were found.In 101 cases,recover,85 cases,good,12 cases.Minor linit of joint in 4 cases due to joint surface was involved.Conclusiong:Suitable family rehabilitation could promote recovery o fracture and reduce incidence of complications.     

老年人髋部骨折的康复治疗

60岁以上的老人髋部骨折非常常见,治疗需较长时间的卧床,容易产生废用综合征,导致终生残疾,甚至危及生命,康复治疗是预防及治疗废用综合征的重要措施,并能使患者尽可能恢复到伤前的活动能力。作者分析了153例老人髋部骨折,男性61例,女性92例,其中股骨颈骨折72例,粗隆间骨折81例。提出了于术前、术后及出院后家庭康复治疗的具体方法。按出院后1年患者活动能力的恢复,关节功能情况,分优、良、可、差四级评定,优良共121例,占83.4％。作者强调了康复治疗的必要性和可行性。     

老年性白内障手术病人的康复护理

白内障是我国老年人常见的致盲眼病,随着人口老龄化的发展,其发病率显著增加。为此,作者从术前护理、术后护理、出院指导等方面综述了手术治疗白内障的康复护理。     

PCCP治疗高龄股骨转子间骨折患者的围术期护理

目的总结经皮加压钢板（PCCP）治疗高龄股骨转子间骨折患者围术期护理经验。方法分析75例65岁以上股骨转子间骨折患者的临床及护理资料,根据老年人的病理生理与心理特点,有针对性地预防并发症,进行功能锻炼。结果全部患者的并发症经术前处理相对稳定,全部平稳度过手术期。结论高龄患者手术风险大,根据老年人的生理特点和心理特点,有针对性地实施围术期系统护理是提高手术成功率,减少并发症,改善生存质量的重要保证。     

Rehabilitation outcome of elderly patients with hip fracture and cognitive impairment

Purpose:?To assess the association between cognitive status and functional gain during a rehabilitation programme for elderly patients with hip fracture.

Method:?Prospective study in a hospital geriatric rehabilitation unit. Sixty-one consecutive patients were studied: 28 with cognitive impairment (age 87.6?±?7.2 years, Mini Mental State Examination (MMSE) score 11.25?±?5.9), 23 with possible cognitive impairment (age 83.9?±?6.8 years, MMSE 22.65?±?1.6) and 10 without cognitive impairment (age 77.6?±?7.4 years, MMSE 29.5?±?0.9). Cognitive status was assessed with the MMSE and admission and discharge functional status with the Functional Independence Measure (FIM). Functional gain was calculated by absolute FIM gain (admission FIM minus discharge FIM), relative (to maximum potential) FIM gain with the Montebello Rehabilitation Factor Score (MRFS) and analysis of covariance of the FIM (ANCOVA).

Results:?Patients without cognitive impairment had significantly higher admission FIM and discharge FIM. Cognitive status was not significantly associated with absolute functional gain. The adjusted (age, gender, sensory impairment, nutritional status, comorbidity and treatment) MRFS score of cognitively impaired patients was significantly lower (p?<?0.03). However, the functional gain related to baseline functional status (ANCOVA) was not significantly different between the groups.

Conclusions:?In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes.     

Rehabilitation outcome of elderly patients with hip fracture and cognitive impairment

PURPOSE: To assess the association between cognitive status and functional gain during a rehabilitation programme for elderly patients with hip fracture. METHOD: Prospective study in a hospital geriatric rehabilitation unit. Sixty-one consecutive patients were studied: 28 with cognitive impairment (age 87.6 +/- 7.2 years, Mini Mental State Examination (MMSE) score 11.25 +/- 5.9), 23 with possible cognitive impairment (age 83.9 +/- 6.8 years, MMSE 22.65 +/- 1.6) and 10 without cognitive impairment (age 77.6 +/- 7.4 years, MMSE 29.5 +/- 0.9). Cognitive status was assessed with the MMSE and admission and discharge functional status with the Functional Independence Measure (FIM). Functional gain was calculated by absolute FIM gain (admission FIM minus discharge FIM), relative (to maximum potential) FIM gain with the Montebello Rehabilitation Factor Score (MRFS) and analysis of covariance of the FIM (ANCOVA). RESULTS: Patients without cognitive impairment had significantly higher admission FIM and discharge FIM. Cognitive status was not significantly associated with absolute functional gain. The adjusted (age, gender, sensory impairment, nutritional status, comorbidity and treatment) MRFS score of cognitively impaired patients was significantly lower (p < 0.03). However, the functional gain related to baseline functional status (ANCOVA) was not significantly different between the groups. CONCLUSIONS: In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes.     

人工股骨头置换术老年患者的护理

目的探讨人工股骨头置换治疗老年患者股骨颈骨折术前和术后的护理方法。方法对158例股骨颈骨折的老年患者行人工股骨头置换术,术前心理护理,术后注重生命体征、预防并发症及功能锻炼指导。结果 158例老年患者术后无并发症发生。结论对老年人工股骨头置换术患者必须进行充分的术前指导和术后护理措施,从而使患者达到预期康复。     

Rehabilitation following stroke in patients aged 85 and above

To assess the course and results of rehabilitation following stroke in the oldest old, we conducted a prospective study to compare 45 patients 85 years and above and 220 consecutive patients aged 75 to 84 years who were hospitalized for rehabilitation following stroke. Functional status was measured and compared by the Functional Independence Measuretrade mark(FIM) scale and successful rehabilitation was defined as FIM > 80 at discharge. Eighteen patients in the 85+ group (40%) underwent successful rehabilitation compared with 115 (52%) in the 75 to 84 group (not significant). No significant differences were found between the groups in any other parameters that measure success and/or efficacy of rehabilitation, but in all these parameters, without exception, there were lower values in the 85+ group. No differences in the length of rehabilitation and complications rates were found between groups. We conclude that although the success rate for rehabilitation following stroke is lower in the oldest old, it appears that the effort invested in rehabilitating patients in this group is no less justified than in younger elderly patients.     

髋臼骨折病人切开复位术后的康复护理

髋臼骨折是骨盆骨折的一种特殊类型,往往是高能量创伤的结果,移位的骨折造成髋臼与股骨头关节软骨之间的不适合,容易继发创伤性骨关节炎;     

老年股骨颈骨折患者人工股骨头置换术围手术期护理

通过了解老年人生理及心理特点，重视心理护理，做好术前准备、术中配合及术后护理．积极预防并发症．辅以功能锻炼，全面提高围手术期护理质量。4年来，对97例老年股骨颈骨折患者人工股骨头置换术围手术期的护理，病人术后生活全部自理。无任何并发症发生。     

应用可吸收螺钉生物学特点指导髌骨骨折患者术后康复

目的:由于材料强度的限制,应用可吸收螺钉固定髌骨骨折术后通常需要进行外固定,结合这一特点,指导患者术后进行渐进性康复训练,观察膝关节功能恢复效果. 方法:2004-06/2006-06上海交通大学附属上海市第六人民医院收治髌骨骨折患者35例,其中横型骨折27例,粉碎型骨折8例.均采用芬兰BIONX公司提供的BIOFIX(百优)自身增强聚丙交酯(SR-PLLA)可吸收螺钉治疗,术后即开始股四头肌等长收缩训练,并进行渐进性膝关节活动度训练.以膝关节功能恢复和影像检查综合判断疗效,优为膝关节功能正常,良为膝关节功能接近正常,下蹲稍差.结果:35例均完成治疗和康复,术后随访≥ 12个月,平均22个月.平均愈合时间为6周;疗效优29例,良6例;术后出现并发症2例,均为伤口周围红肿反应.结论:自身增强聚丙交酯可吸收螺钉治疗髌骨骨折及适当术后康复可避免二次手术,并可取得良好的治疗效果.