分级活动在全髋关节置换术患者中的应用
【摘要】目的 探讨分级活动对全髋关节置换患者术后谵妄的干预效果。方法 选取2024年1月至2025年1月于中山大学附属第三医院进行治疗的100例≥50岁的全髋关节置换术后患者为研究对象，按照随机数字表法分为干预组和对照组各50例。对照组实行术后常规护理，干预组术后返回病房即开始按分级活动方案进行干预。比较两组患者谵妄发生率、Harris髋关节功能评分、匹兹堡睡眠质量指数（PSQI）评分、平均住院天数、平均住院费用和满意度的差异。结果 干预组术后谵妄发生率显著低于对照组（4% vs. 18%，P?< 0.05）。Harris髋关节功能评分总分及分项结果显示，干预组总分（80.94 ± 7.53 vs. 76.54 ± 5.95）、疼痛评分（37.36 ± 5.22 vs. 34.96 ± 5.22）和关节功能评分（38.64 ± 3.84 vs. 36.96 ± 3.79）均显著高于对照组（P?< 0.05），在畸形及活动度方面无统计学差异（P?> 0.05）。此外，干预组入睡困难发生率（10.0% vs. 28.0%）、平均住院天数（11.86 ± 2.61 d vs. 13.42 ± 2.95 d）、住院费用（33,581.16 ± 6,257.20元 vs. 38,438.72 ± 7,816.95元）及满意率（94.0% vs. 78.0%）均显著优于对照组（P?< 0.05）。结论 分级活动可预防全髋关节置换患者术后谵妄的发生，减轻患者术后疼痛、改善关节功能及睡眠质量，减少平均住院天数和住院费用，提高患者的满意度。
Abstract Objective: To explore the intervention effect of grading activities on postoperative delirium in patients undergoing total hip arthroplasty. Method: 100 patients aged ≥ 50 years who underwent total hip arthroplasty in the Third Affiliated Hospital of Sun Yat-sen University from January 2024 to January 2025 were selected as the study subjects. They were randomly divided into an experimental group and a control group, with 50 patients in each group, using a random number table method. The control group received routine postoperative care, while the experimental group began intervention according to the early grading activity plan upon returning to the ward after surgery. Compare the incidence of delirium, Harris Hip Joint Function Scale, Pittsburgh Sleep Quality Index score, average length of hospital stays, average hospital expenses, and satisfaction between two groups of patients. Result: The incidence of postoperative delirium was significantly lower in the experimental group than in the control group (4% vs. 18%, P < 0.05). The results of the Harris Hip Function Score (HHFS) total score and sub-scores showed that the experimental group had a significantly higher total score (80.94 ± 7.53 vs. 76.54 ± 5.95), pain score (37.36 ± 5.22 vs. 34.96 ± 5.22) and joint function score ( 38.64 ± 3.84 vs. 36.96 ± 3.79) were significantly higher than those of the control group (P < 0.05), but there was no statistically significant difference between the two groups in terms of deformity and mobility (P > 0.05). In addition, the incidence rate of difficulty in sleeping (10.0% vs. 28.0%), the mean number of days of hospitalisation (11.86 ± 2.61 d vs. 13.42 ± 2.95 d), the cost of hospitalisation (33,581.16 ± 6,257.20 yuan vs. 38,438.72 ± 7,816.95 yuan), and the satisfaction rate (94.0% vs. 78.0%) in the experimental group were all were significantly better than those of the control group (P < 0.05). Conclusion: Early grading activities can prevent postoperative delirium in patients undergoing total hip arthroplasty, alleviate postoperative pain, improve joint function and sleep quality, reduce average length of hospital stay and hospitalization costs, and increase patient satisfaction.
梁晓玲、杨叶香、王昆、梁堂钊、管丹丹
临床医学医学研究方法
全髋关节置换术术后谵妄分级活动关节疼痛关节功能
otal Hip ArthroplastyPostoperative DeliriumGrading activitiesJoint painJoint function
梁晓玲,杨叶香,王昆,梁堂钊,管丹丹.分级活动在全髋关节置换术患者中的应用[EB/OL].(2025-06-08)[2025-08-02].https://www.biomedrxiv.org.cn/article/doi/bmr.202507.00043.点此复制
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