 苏奶奶今年84岁，近三周前在家附近摔了一跤，左髋出现疼痛，医院检查确定为左侧股骨颈骨折，于是进行左侧全髋关节置换术,手术很成功。 Grandma Su is 84 years old. Three weeks ago she fell near her home, and started feeling pain in her left hip. The hospital examined her and confirmed she had a left femoral neck fracture, so they performed a total left hip arthroplasty, which was very successful.  苏奶奶在同仁医院特需病房卧床已经16天了，吃喝拉撒睡均在床上，似乎一切都要依靠护工阿姨了，因此心情很是低落。 Grandma Su has now been in the VIP room at Tongren Hospital for 16 days, performing all basic daily needs without leaving the bed. Every part of her life seemed to depend on her healthcare worker, and it made her feel depressed.   经康复科治疗师评估下来，苏奶奶现在的情况是可以活动的。因为此时的苏奶奶术后疼痛和肿胀已经得以控制，身体基本体征平稳，如果患者继续卧床，人会越来越虚弱，心肺功能下降，增加肺炎发生率，下肢肌肉进一步萎缩，再想站立行走就更困难啦……” Based on the assessment of the rehabilitation therapist, Grandma Su can be active now. Since Grandma Su’s post-surgery pain and swelling are already under control, and her basic physical signs are stable, staying in bed would only make her weaker. Her heart and lung functions would decline, the likelihood of pneumonia would increase, and her lower limb muscles would atrophy further. Standing and walking would become even more difficult.  那么如何动？这是个问题... How do I move? That is the question…  首先我们注意髋关节置换的术式：后外侧入路还是前外侧入路？因为两者的术后禁忌动作有所不同。 First we need to know which approach of hip joint replacement surgery was used: the posterolateral approach or the anterolateral approach? This is because the prohibited movements after each of these surgeries is different.  后外侧 posterolateral 髋关节屈曲禁止超过90° Bending of hip bone past 90° prohibited 内收禁止超过身体中线 Adduction past body midline prohibited 禁止内旋 Internal rotation prohibited 前外侧 anterolateral 髋关节屈曲禁止超过90° Bending of hip bone past 90° prohibited 内收禁止超过身体中线 Adduction past body midline prohibited 禁止外旋 External rotation prohibited    其次我们关注的是术后患者应该如何运动，从而提高的生活自理能力： Secondly, we want to know how the patient should exercise post-surgery in order to improve self-care ability. 术后1-2天 1-2 days after surgery 1 目标 Goal 预防术后并发症，增加肌肉收缩，加强患肢控制，使患者对于髋关节置换术后防范的理解 Prevent postoperative complications, increase muscle contractions, improve control of affected limb, boost patient’s understanding of precautions after a hip joint replacement surgery. 2 康复内容 Rehabilitation content 股四头肌和臀肌等长收缩、踝泵、髋关节外展、床边屈髋屈膝、开展转移卧-坐训练，此时踝关节不宜做旋转动作，因为患者可能无意间会将患肢内旋，导致脱位。 Quadriceps and gluteus isometric contraction, ankle pumps, hip joint abduction, bedside hip and knee flexes, extended and rotating sit-ups. At this point the ankle should not make any circular movements, because the patient may unintentionally rotate the affected limb internally, causing dislocation. 《踝泵运动》 ankle pumps 股四头肌和臀肌等长收缩 quadriceps and gluteus isometric contraction 床边屈髋屈膝 bedside hip and knee flexes 术后3-7天 3-7 days after surgery ★ 目标 Goal 提高转移和行走独立性（借助辅助工具），加强术后防范，出院回家。 Improve ability to move and walk on own (using auxiliary aids), strengthen postoperative precautions, discharge from hospital and return home. 康复内容 Rehabilitation content 增加指导上下楼梯训练、平地行走训练 increase directed stairs training, level ground walking training 术后1-6周 1-6 weeks after surgery
苏奶奶在康复治疗师的指导下，开始尝试在床边坐位，接下来的一周里，苏奶奶一边通过指导在床上做加强肌力的动作，一边尝试自己站立，很快苏奶奶就能在助行器的辅助下进行行走。 Under the guidance of the rehabilitation therapist, Grandma Su attempted sitting on the edge of the bed. In the week that followed, she did guided muscle-strengthening movements in bed, while also trying to stand up by herself. Grandma Su was quickly able to start walking with the help of mobility aids. 1 专家介绍 Expert Introducation 李艳，康复科主任 Yan Li Rehabilitation Chief Physician 康复医学与理疗学硕士 Master of rehabilitation medicine and physiotherapy 中国康复医学会康复医学教育专委会委员、上海康复医学会重症康复委员会委员 Member of special committee of rehabilitation medical education of Chinese association of rehabilitation medicine, member of committee of intensive care rehabilitation of Shanghai association of rehabilitation medicine 从事临床工作20多年 More than 20 years of work experienced in medical services 擅长： Specialties:
2 我们的团队 Our Team 科室现有各类医务人员共38名，目前开放康复床位20张。我们是一支专业的康复团队，正默默地守护着您， 只要您有需要，我们将给予您最大的帮助！ 如需咨询请联系：52039999-72332 There are 38 medical staff in the rehabilitation department, and 20 rehabilitation beds are opened We are a professional rehabilitation team is silently guarding you, if you need, we will give you the greatest help! For further information, please contact: 52039999-72332 预约 素材提供：李艳、汤莉 编辑、排版、翻译：何濛濛 上海交通大学医学院附属同仁医院 |
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