术中保温联合早期系统化康复训练对老年全髋关节置换术患者凝血功能、康复效果和生活质量的影响

摘要 目的：观察术中保温联合早期系统化康复训练对老年全髋关节置换术（THA）患者凝血功能、康复效果和生活质量的影响。方法：选择我院2018年8月～2021年8月期间收治的80例老年THA患者，按随机数字表法将其分为对照组（40例）和观察组（40例）。对照组患者接受早期系统化康复训练，观察组患者接受术中保温联合早期系统化康复训练，对比两组术中低体温发生率、凝血功能、康复效果和生活质量。结果：观察组的术中低体温发生率明显低于对照组（P<0.05）。观察组的下床活动时间、住院时间短于对照组（P<0.05）。两组术后8周Harris髋关节功能评分均升高，且观察组高于对照组（P<0.05）。对照组术后7 d凝血酶原时间(PT) 、活化部分凝血活酶时间( APTT) 及凝血酶时间( TT) 、纤维蛋白原（FIB）均升高（P<0.05），观察组术前、术后7 d PT、APTT、TT、FIB组内对比无统计学差异（P>0.05），观察组术后7 d PT、APTT、TT、FIB低于对照组（P<0.05）。对照组术后6个月躯体职能、角色职能、情绪职能、认知职能、社会职能评分升高，且观察组高于对照组（P<0.05）。结论：术中保温联合早期系统化康复训练可促进老年THA患者康复，有效保护机体凝血功能，促进患者生活质量提高，效果显著。

Effects of Intraoperative Thermal Insulation Combined with Early Systematic Rehabilitation Training on Coagulation Function, Rehabilitation Effect and Quality of Life in Elderly Patients Undergoing Total Hip Arthroplasty

ABSTRACT Objective: To observe the effects of intraoperative thermal insulation combined with early systematic rehabilitation training on coagulation function, rehabilitation effect and quality of life in elderly patients undergoing total hip arthroplasty (THA). Methods: 80 elderly patients with THA who were treated in our hospital from August 2018 to August 2021 were selected, and they were randomly divided into control group (40 cases) and observation group (40 cases) by random number table method. The patients in the control group received early systematic rehabilitation training, and the patients in the observation group received intraoperative thermal insulation combined with early systematic rehabilitation training. The incidence of intraoperative hypothermia, coagulation function, rehabilitation effect and quality of life were compared between the two groups. Results: The incidence of intraoperative hypothermia in the observation group was significantly lower than that in the control group(P<0.05). The getting out of bed time and hospitalization time in the observation group were shorter than those in the control group(P<0.05). Harris hip function score in the two groups at 8 weeks after operation increased, and the observation group was higher than the control group (P<0.05). Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) in the control group at 7 d after operation increased (P<0.05). There were no significant differences in PT, APTT, TT and FIB groups in the observation group before operation and 7 d after operation(P>0.05). PT, APTT, TT and FIB in the observation group at 7 d after operation were lower than those in the control group(P<0.05). The scores of physical function, role function, emotional function, cognitive function and social function in the control group at 6 months after operation increased, and the observation group was higher than the control group (P<0.05). Conclusion: Intraoperative thermal insulation combined with early systematic rehabilitation training can promote the rehabilitation of elderly patients with THA, effectively protect the coagulation function, and improve the quality of life of patients, with remarkable effects.