摘要
目的探讨基于健康信念模式(the health belief model,HBM)的康复治疗对绝经后骨质疏松性髋部骨折病人恢复的影响。方法选取2014年6月至2017年1月在我院行动力髋部螺钉内固定术和髓内钉内固定术的绝经后骨质疏松性髋部骨折住院病人60例。按入院顺序采用随机数字表法分为观察组和对照组,各30例。观察组术后给予基于HBM的康复治疗,对照组术后给予常规康复治疗。康复治疗前后,采用Harris髋关节功能评分量表和Barthel指数(Barthel index,BI)评定量表评估病人的功能恢复情况,采用疼痛视觉模拟量表(visual analogue scale,VAS)评估疼痛程度,并观察两组病人康复治疗前后腰椎正位(L_2～L_4)、健侧股骨颈、Ward's三角区的骨密度、骨碱性磷酸酶(bone alkaline phosphatase,BALP)水平的变化。结果治疗后两组Harris髋关节功能评分、Barthel指数评分比较,观察组均优于对照组,差异均有统计学意义(t=2.409,P=0.019;t=2.394,P=0.020);治疗后两组VAS评分比较,观察组明显优于对照组,差异有统计学意义(t=4.691,P<0.001);治疗后两组腰椎正位(L_2～L_4)、健侧股骨颈、Ward's三角区的骨密度比较,观察组均明显高于对照组,差异均有统计学意义(t=2.125,P=0.038;t=2.819,P=0.007;t=2.067,P=0.043);治疗后两组BALP比较,观察组明显低于对照组,差异有统计学意义(t=2.295,P=0.025)。结论基于HBM的康复治疗能有效增加骨密度,降低BALP水平,促进绝经后骨质疏松性髋部骨折病人的功能恢复,并提高了病人日常生活自理能力。
Objective To investigate the effects of rehabilitation therapy based on the health belief model(HBM) on recovery of patients with postmenopausal osteoporotic hip fracture.Methods Sixty patients with postmenopausal osteoporotic hip fracture undergoing dynamic hip screw internal fixation and intramedullary nail internal fixation in our hospital from June 2014 to January 2017 were selected. According to the order of admission, the patients were divided into observation group and control group with 30 cases in each group. The observation group received HBM-based rehabilitation therapy and the control group received conventional rehabilitation therapy. Harris score and Barthel index(BI) scale were used to assess the functional recovery of patients. And the pain degree was assessed by visual analogue scale(VAS). The changes of bone mineral density(BMD) and bone alkaline phosphatase(BALP) levels in lumbar vertebrae(L2-L4), contralateral femoral neck and Ward’s triangle before and after rehabilitation therapy were observed.Results The Harris hip function score and BI score in observation group were significantly higher than those in control group after treatment(t=2.409, P=0.019;t=2.394, P=0.020). The VAS score in observation group was significantly lower than that in control group(t=4.691, P<0.001). The BMD levels at location in observation were significantly higher than those in control group, and there were significant differences between the two groups(t=2.125, P=0.038;t=2.819, P=0.007;t=2.067, P=0.043). The BALP levels in observation group were significantly lower than those in control group(t=2.295, P=0.025).Conclusion Rehabilitation treatment based on HBM can effectively increase BMD levels, decrease BALP levels, promote the functional recovery of patients withpostmenopausal osteoporotic hip fracture, and improve the ability of activities of daily living.
作者
谢旖静
张鹏
孙伟
XIE Yi-jing;ZHANG Peng;SUN Wei(Department of Orthopaedics,Emergency General Hospital,Beijing 100028,China;Department of Urology,Emergency General Hospital,Beijing 100028,China)
出处
《骨科》
CAS
2019年第2期140-145,共6页
ORTHOPAEDICS
关键词
髋部骨折
健康信念模式
康复治疗
骨密度
骨碱性磷酸酶
Hip fracture
Health belief model
Rehabilitation treatment
Bone mineral density
Bone alkaline phosphatase
