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目的探讨Rüedi-AllgowerⅢ型Pilon骨折围术期护理及术后康复指导的疗效。方法收集病例66例,将患者根据康复锻炼时间分为二组,其中一周内开始功能锻炼有36例,一周后开始功能锻炼有30例,针对性的进行心理、术前和术后科学护理干预,术后进行康复指导和功能锻炼,根据Mazur踝关节功能评分和并发症的发生情况进行功能评价,比较二组踝关节功能优良率。结果所有66例术后随访11~24个月,平均15.8个月。骨折临床愈合时间7~15周,平均10.6周,骨折延迟愈合2例,未出现骨不连、创伤性关节炎等并发症的发生。Mazur功能评分优28例、良27例、可7例、差4例,总优良率83.3%,1周内和1周后开始功能康复锻炼患者优良率分别为91.7%和73.3%,差异有统计学意义(P<0.05)。结论科学的护理和早期合理康复锻炼可有效提高手术疗效、减少并发症发生和促进患者康复。
Objective To investigate the curative effect of perioperative nursing and postoperative rehabilitation guidance for Rüedi-Allgower Ⅲ type Pilon fracture. Methods Sixty-six cases were collected. Patients were divided into two groups according to the rehabilitation exercise time: 36 cases started functional exercise in one week, 30 cases started functional exercise after one week. Psychological, preoperative and postoperative nursing interventions , Postoperative rehabilitation guidance and functional exercise, according to Mazur ankle function scores and complications of functional evaluation, comparison of two groups of ankle function excellent rate. Results All 66 patients were followed up for 11-24 months with an average of 15.8 months. Fracture clinical healing time 7 to 15 weeks, an average of 10.6 weeks, delayed union in 2 cases, no complications such as nonunion, traumatic arthritis occurred. The excellent and good rates of Mazur functional score were 28 cases, good in 27 cases, fair in 7 cases and poor in 4 cases, with a total excellent and good rate of 83.3%. The excellent and good rates of functional rehabilitation were 91.7% and 73.3% in 1 week and 1 week, respectively Significance (P <0.05). Conclusion Scientific nursing and early rehabilitation exercise can effectively improve the surgical efficacy, reduce the incidence of complications and promote patient rehabilitation.