自主突破康复法对复杂踝关节骨折脱位患者术后康复效果、恢复期生活质量的影响

  目的  探讨自主突破康复对复杂踝关节骨折脱位患者术后活动、疼痛和恢复的影响。  方法  选取于2018年1月～2018年11月在唐山市第二医院接受治疗的复杂踝关节骨折脱位患者90例，随机分为观察组和对照组，各45例。对照组接受常规骨科护理康复，观察组接受自主突破康复法，对比分析2组患者术后康复效果、疼痛情况。  结果  观察组总有效率和康复程度显著高于对照组，并发症发生率以及疼痛情况均显著低于对照组（χ2 = 6.944、12.600、8.389、6.480，P < 0.05）。术后12 h、术后1 d和术后2 d观察组患者的VAS评分均显著低于对照组（t = -9.354、-6.934、-6.911，P < 0.001），下床活动、完全负重、住院、骨折愈合时间均显著短于对照组（t = -13.094、-9.615、-14.795、-7.857，P < 0.001）。观察组患者的手术时间、出血量和术后感染例数均显著低于对照组（t = 2.247、4.115，χ2 = 5.215，P < 0.05）。  结论  自主突破应用于复杂踝关节骨折脱位患者能够有效减轻患者疼痛，有着较好的临床疗效和康复效果，患者生活质量明显提高且患者的满意度高。

Effect of Independent Breakthrough Rehabilitation Method on Postoperative Rehabilitation Effect and Quality of Life in Patients with Complicated Ankle Fracture and Dislocation

  Objective  To explore the effects of autonomous breakthrough nursing on postoperative activities, pain and recovery in patients with complex ankle fracture and dislocation.   Methods  A total of 90 patients with complex ankle fractures and dislocations who admitted in our hospital for treatment from January 2018 to November 2018 were selected and randomly divided into observation group and control group, with 45 cases in each group. The control group received conventional orthopedic nursing and rehabilitation, and the observation group received independent breakthrough rehabilitation method. The postoperative rehabilitation effect and pain condition of the two groups were compared and analyzed.   Results  The total effective rate and rehabilitation degree of the observation group were significantly higher than those of the control group, and the incidence of complications and pain were significantly lower than those of the control group （χ2 = 6.944, 12.600, 8.389, 6.480, P < 0.05）. The VAS scores of patients in the observation group were significantly lower than those in the control group at 12 hours, 1 day and 2 days after operation （t = -9.354, -6.934, -6.911, P < 0.001）. The time of getting out of bed, complete weight-bearing, hospitalization and fracture healing were significantly shorter than those in the control group （t = -13.094, -9.615, -14.795, -7.857, P < 0.001）. The operation time, the amount of bleeding and the number of postoperative infections in the observation group were significantly lower than those in the control group （t = 2.247, 4.115, χ2 = 5.215, P < 0.05）.   Conclusions  Autonomous breakthrough nursing can effectively reduce the pain of patients with complex ankle fracture and dislocation. It has good clinical efficacy and rehabilitation effect, and patient satisfaction is high.