老年髋部骨折内固定术后患者日常生活能力调查及影响因素研究

发布时间：2018-01-20 11:22

本文关键词： 髋部骨折老年患者日常生活能力平衡功能社会支持　出处：《郑州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的了解老年髋部骨折内固定术后患者日常生活能力、平衡功能恢复状况和社会支持情况;分析影响老年髋部骨折内固定术后患者日常生活能力相关因素;为进一步制定老年髋部骨折内固定术后患者的康复策略提供理论依据。方法采用便利抽样的方法,选取2015年1月至2016年1月于郑州大学第一附属医院急诊外科与骨科就诊的股骨颈骨折或股骨转子间骨折并行内固定术治疗的175例老年患者作为研究对象。调查内容包括患者的基本资料、疾病情况、骨折前及术后6个月日常生活能力情况、平衡功能及社会支持情况,分别以ADL量表、Berg平衡功能量表和社会支持评分量表作为调查工具。收集的数据使用Epidata3.1进行录入,采用SPSS17.0进行统计学分析,使用的统计分析方法包括一般性统计学描述、t检验、卡方检验、相关性分析及Logistic回归分析等。结果共收集162例患者有效资料,有效率为92.5%。患者年龄范围65-98岁,平均75.27±3.92岁,男女比例为1:1.54;约半数患者与配偶同住并由配偶照顾,人均收入在1000-3000元者占半数以上。患者住院天数7-21天,平均13.78±6.24天;股骨转子间骨折为88例(54.3%),股骨颈骨折74例(45.7%),大多数为新鲜骨折(93.2%)跌倒导致骨折患者82例,占50.6%;大部分患者在骨折4天后接受手术治疗(121例,74.7%),术前合并疾病前五位依次为脑血管疾病、高血压、心脏病、糖尿病和慢性支气管炎,术后并发症以疼痛和关节僵硬为多。患者骨折前生活能力得分平均为16.84±5.38分,术后6个月则为20.94±7.27分,提示术后患者日常生活能力下降,差异具有统计学意义(t=-2.068,P=0.023),Logistic回归分析结果显示年龄、骨折的稳定性、骨折距手术的时间及术前合并症对术后日常生活能力的影响有统计学意义。患者术后平衡功能得分29.97±15.51分,年龄、骨折稳定性及骨折距手术时间对其影响有统计学意义。社会支持评分均值为39.72±5.77分,与术后日常生活能力得分及平衡功能得分具有相关性(P0.01),提示社会支持越高,患者术后功能恢复越好。结论老年髋部骨折内固定术后患者存在着不同程度的日常生活能力受限及平衡功能恢复不良情况;社会支持可影响老年髋部骨折患者术后康复,即获得的社会支持越高,患者术后日常生活能力及平衡功能的恢复越好。年龄偏大、术前合并有其他疾病、不稳定性骨折、骨折手术时机延迟、术后并发症及获得社会支持少等是老年髋部骨折患者术后日常生活能力和平衡功能恢复不佳的危险因素;另外,性别对患者功能恢复的影响有待进一步探讨。
[Abstract]:Objective to investigate the ability of daily living (ADL), balance function recovery and social support in elderly patients with hip fracture after internal fixation. To analyze the influencing factors of ADL in elderly patients with hip fracture after internal fixation. To provide a theoretical basis for the further development of rehabilitation strategies for elderly patients with hip fracture after internal fixation. Methods convenience sampling method was adopted. From January 2015 to January 2016, 175 elderly patients with femoral neck fracture or femoral intertrochanteric fracture treated with internal fixation in emergency surgery and orthopedic department of the first affiliated Hospital of Zhengzhou University were selected. Subjects. The contents of the investigation included the basic information of the patients. ADL scale was used to measure the disease, daily living ability, balance function and social support before fracture and 6 months after operation. Berg balance function scale and Social support scale were used as investigation tools. The collected data were recorded by Epidata3.1 and analyzed statistically by SPSS17.0. The statistical analysis methods used included general statistical description t test, chi-square test, correlation analysis and Logistic regression analysis. The effective rate was 92.5%. The age range of the patients was 65-98 years (mean 75.27 卤3.92 years). The ratio of male to female was 1: 1.54; About half of the patients lived with their spouses and were taken care of by their spouses. More than half of the patients had a per capita income of 1000-3000 yuan. The patients were hospitalized for 7-21 days with an average of 13.78 卤6.24 days. There were 88 cases of intertrochanteric fracture, 74 cases of femoral neck fracture, most of which were fresh fracture. 82 cases (50.6%) were caused by falling. Most of the patients were treated by operation 4 days after fracture, 121 cases were treated with operation, and the first five diseases were cerebrovascular disease, hypertension, heart disease, diabetes mellitus and chronic bronchitis before operation. The first five cases were cerebrovascular disease, hypertension, heart disease, diabetes mellitus and chronic bronchitis. The postoperative complications were pain and joint stiffness. The average score of life ability before fracture was 16.84 卤5.38, and that of 6 months after operation was 20.94 卤7.27. The results of logistic regression analysis showed that age and fracture stability. The effect of the time of fracture distance and preoperative complications on postoperative ADL was statistically significant. The score of balance function after operation was 29.97 卤15.51, age. The influence of fracture stability and the time of fracture distance operation was statistically significant. The average score of social support was 39.72 卤5.77. There was a correlation with the scores of daily living ability and balance function after operation, indicating that the higher the social support was. Conclusion the elderly patients with hip fracture after internal fixation have different degrees of limited ability of daily living and poor balance function recovery. Social support can affect the postoperative rehabilitation of elderly patients with hip fracture, that is, the higher the social support, the better the recovery of postoperative ADL and balance function. Unstable fracture, delayed operation time, postoperative complications and less social support were the risk factors for the recovery of ADL and balance function in elderly patients with hip fracture. In addition, the effect of gender on functional recovery of patients needs to be further explored.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.6

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