Application of self-service lower limb therapeutic footwear in prevention of deep vein thrombosis after lower limb fracture surgery
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摘要:
目的 下肢骨折术后长期卧床可致使下肢深静脉血栓，影响肢体功能恢复，常规功能锻炼方式需在患者骨折处稳定后开展，恢复慢，需选择一种科学规范的锻炼方式。本研究用软底舞蹈鞋和绷带两条制成自助式功能锻炼鞋，分析自助式下肢功能锻炼鞋在下肢骨折术后的作用。 方法 选择2016年8月—2018年8月温州医科大学附属第二医院收治的120例下肢骨折手术患者，按照抽签法分组。对照组60例，行常规锻炼，观察组60例，在功能锻炼中使用自助式下肢功能锻炼鞋，比较2组患者深静脉血栓发生率、大小腿内径、下肢肿胀度、踝关节功能和下肢功能。 结果 观察组下肢深静脉血栓发生率低于对照组(P＜0.05)；观察组小腿周径为(28.16±1.96)cm、大腿周径为(53.24±2.56)cm。肿胀程度评分为(0.78±0.12)分，低于对照组，踝关节功能、下肢运动和平衡功能评分分别为(81.54±1.69)分、(30.12±1.27)分和(42.78±1.98)分，高于对照组(均P＜0.05)。 结论 下肢骨折患者术后使用自助式下肢功能锻炼鞋，可预防下肢深静脉血栓，缓解下肢肿胀，对患者踝关节和下肢功能改善作用明显，可在增加样本数量，延长研究时间的基础上，对自助式下肢功能锻炼鞋在下肢骨折术后的应用价值予以深入探讨。 -
关键词:
- 自助式下肢功能锻炼鞋 /
- 下肢骨折 /
- 深静脉血栓 /
- 踝关节功能 /
- 下肢功能
Abstract:Objective Staying in bed for a long time due to lower limb fractures can cause postoperative deep vein thrombosis of lower limb, affecting limb function recovery. The conventional way of functional exercise should be carried out by patients after the fracture is stable, However, by this means the recovery of limb function is slow, and a scientific and standardized exercise method is needed. In this study self-service lower limb functional therapeutic footwear were made from soft bottom shoes and two bandage to analyse the role of self-service lower limb functional therapeutic footwear on the recovery of lower limb fracture. Methods A total of 120 patients with lower extremity fracture from August 2016 to August 2012 were studied and divided into groups according to the lottery method. Sixty patients in the control group received regular exercise, and 60 patients in the observation group used self-service lower limb therapeutic footwear during functional exercise. The incidence of deep vein thrombosis, inner diameter of lower leg, swelling degree of lower limb, ankle joint function and lower limb function in the two groups were compared. Results The incidence of lower extremity deep vein thrombosis in the observation group was lower than that in the control group (P < 0.05). In the observation group, the circumference of calf and thigh were (28.16±1.96) cm and (53.24±2.56) cm, respectively. The score of swelling degree was (0.78±0.12) points, which was lower than that of the control group. The score of ankle function, lower limb movement and balance function of the observation group were (81.54±1.69) points, (30.12±1.27) points and (42.78±1.98) points, respectively, which were higher than that of the control group (all P < 0.05). Conclusion For patients with lower limb fracture surgery, using self-service lower limb therapeutic footwear can prevent deep vein thrombosis of lower limb and relieve swelling in the lower extremities. Patients with obvious discomfort can achieve improved ankle and lower limb function. The number of samples can be increased to extend this study. The application value of self-service in lower limb functional exercise shoes on the lower limb fracture can be deeply explored. -
表 1 2组下肢骨折手术患者下肢深静脉血栓发生情况比较[例(%)]
组别 例数 干预1个月后 干预3个月后 对照组 60 15(25.00) 11(18.33) 观察组 60 3(5.00) 2(3.33) χ2值 9.411 6.987 P值 0.002 0.008 
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表 2 2组下肢骨折手术患者大腿、小腿周径及下肢肿胀程度评分比较(x±s)
组别 例数 小腿周径(cm) 大腿周径(cm) 肿胀程度评分(分) 干预前 干预后 干预前 干预后 干预前 干预后 对照组 60 42.21±3.15 34.19±2.72 66.78±5.45 60.21±3.32 1.98±0.24 1.27±0.18 观察组 60 41.78±3.24 28.16±1.96 66.86±5.48 53.24±2.56 1.96±0.21 0.78±0.12 t值 0.737 13.932 0.080 12.878 0.486 17.545 P值 0.463 ＜0.001 0.936 ＜0.001 0.628 ＜0.001
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表 3 2组下肢骨折手术患者干预前后AOFAS踝-后足评分比较(x±s，分)
组别 例数 踝关节功能评分 干预前 干预后 对照组 60 60.12±4.54 72.36±2.12 观察组 60 59.78±4.32 81.54±1.69 t值 0.420 26.228 P值 0.675 ＜0.001
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表 4 2组下肢骨折手术患者干预前后下肢功能比较(x±s，分)
组别 例数 FMA BBS 干预前 干预后 干预前 干预后 对照组 60 21.78±2.64 25.45±1.56 28.24±4.32 36.15±2.72 观察组 60 21.84±2.72 30.12±1.27 28.16±4.12 42.78±1.98 t值 0.123 17.983 0.014 15.265 P值 0.903 ＜0.001 0.918 ＜0.001
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