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目的探究围手术期锻炼对髋关节置换患者手术隐性失血的影响。方法选取2014年7月至2016年7月骨科初次接受髋关节置换术的350例患者为研究对象,按照随机数表将患者分为观察组与对照组,各175例。对照组给予围手术期常规护理,观察组在对照组基础上进行围手术期锻炼。测定术前1 d与术后3 d的红细胞比容,记录患者手术前后的血红蛋白水平变化;记录两组患者实际失血总量并计算其术后隐性失血量;运用Harris各项评分评价两组患者术后恢复状况。结果两组患者术前1 d血红蛋白水平比较无统计学差异(P>0.05);术后两组血红蛋白水平均较术前降低,观察组高于对照组,差异有统计学意义(P<0.05)。观察组隐性失血量、实际失血总量少于对照组,隐性失血发生率低于对照组,差异均有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(8.0%vs 14.9%,P<0.05)。观察组Harris评分的疼痛、关节功能、关节活动、畸形四项评分均高于对照组,差异有统计学意义(P均<0.05)。结论围手术期锻炼可减少髋关节置换患者手术的隐性失血量,防止其出现贫血及深静脉栓塞等并发症,帮助患者及早恢复独立行走能力。
Objective To investigate the effect of perioperative exercise on occult blood loss in patients undergoing hip joint replacement. Methods From July 2014 to July 2016, 350 patients who underwent initial hip replacement in orthopedics were selected as the study subjects. Patients were divided into observation group and control group according to random number table, each with 175 cases. The control group was given perioperative routine nursing, observation group perioperative period on the basis of the control group. The hematocrit of 1 d preoperatively and 3 d postoperatively was recorded, and the changes of hemoglobin before and after the operation were recorded. The actual blood loss of the two groups was recorded and the postoperative blood loss was recorded. Harris scores were used to evaluate the changes of hemoglobin level Postoperative recovery of patients. Results There was no significant difference in hemoglobin level at 1 day before operation in both groups (P> 0.05). The hemoglobin levels in both groups were lower than those before operation in the two groups, and the difference was statistically significant (P <0.05) . The latent blood loss in the observation group was lower than that in the control group, and the incidence of occult blood loss was lower than that in the control group (P <0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, with a significant difference (8.0% vs 14.9%, P <0.05). Harris score of the observation group pain, joint function, joint activity, deformity four scores were higher than the control group, the difference was statistically significant (P all <0.05). Conclusion Perioperative exercise can reduce the hidden blood loss of patients undergoing hip replacement surgery to prevent complications such as anemia and deep venous thrombosis and help patients recover their ability to walk independently.