持续性被动锻炼康复护理对行跟骨外侧壁骨皮瓣截骨入路跟骨关节内[摘要]目的?^察持续性被动锻炼康复护理对行跟骨外侧壁骨皮瓣截骨入路跟骨关节内骨折患者的效果。方法选择2014年4月～2015年12月在我院接受手术治疗的跟骨关节内移位骨折患者114例作为研究对象，所有患者均采用“L”形切口、跟骨外侧壁骨皮瓣截骨入路方式。采用随机数字表法将其随机分为对照组和观察组，每组57例。其中对照组患者接受常规护理，观察组患者接受持续性被动锻炼联合康复护理，比较两组骨折愈合时间；对患者进行随访，比较两组患者手术后12个月时的跟骨复位率、Bohler角、Gissane角、及Maryland足部评分系统评分及切口相关并发症发生率；术后6个月时应用SF-36生活质量量表对两组患者的生活质量进行评估。结果（1）观察组患者骨折愈合时间明显短于对照组，Bohler角、Gissane角恢复情况明显优于对照组，切口相关并发症发生率明显低于对照组（P<0.05）；（2）观察组患者跟骨高度和宽度的复位率明显优于对照组（P<0.05）；（3）术后观察组患者Maryland足部评分明显优于对照组（P<0.05）；（4）两组患者护理干预后各项生活质量评分均明显提高，且观察组各项评分均明显高于对照组（P<0.05）。结论持续性被动锻炼联合康复护理应用于行跟骨外侧壁骨皮瓣截骨入路术的跟骨关节内骨折患者效果显著，可获得满意的复位效果，能有效减少软组织并发症的发生，促进患者术后踝关节功能的恢复，还可大幅改善患者的生活质量，临床应用价值较高，值得推广应用。[关键词]跟骨关节内骨折；骨折内固定；持续性被动锻炼；康复护理[]R687.3[文献标识码]B[]1673-9701（2017）13-0139-05[Abstract]ObjectiveToobservetheeffectofcontinuepassivemotionrehabilitationcareonthetreatmentofintraarticularcalcanealfracturepatientswhounderwenttheapproachofcalcaneallateralwallflaposteotomy.MethodsAtotalof114patientswithintra-articularfracturestreatedwithsurgeryinourhospitalfromApril2014toDecember2015werechosen.Allpatientsunderwentan"L"-shapedincisionandthecalcaneallateralwallflaposteotomyapproach.Thepatientswererandomlydividedintocontrolgroupandobservationgroup，with57casesineachgroup.Thepatientsinthecontrolgroupweretreatedwithroutinenursingcare.Thepatientsintheobservationgroupreceivedcontinuepassivemotioncombinedwithrehabilitationnursing.Thehealingtimebetweenthetwogroupswascompared.Thepatientsinthetwogroupswerefolloweduptocomparecalcaneusreductionrate，Bohlerangle，Gissaneangle，andMarylandfootscoringsystemscoreandincision-relatedcomplicationrateat12monthsafteroperation.Meanwhile，thequalityoflifeinpatientsbetweenthetwogroupswasassessedbytheSF-36QualityofLifeScaleat6monthsaftersurgery.Results（1）Thetimeoffracturehealingwassignificantlyshorterintheobservationgroupthanthatinthecontrolgroup，andtherecoverystatusofBohlerangleandGissaneanglewassignificantlybetterthanthatofthecontrolgroup.Theincidenceofincision-relatedcomplicationswassignificantlylowerthanthatofthecontrolgroup（P<0.05）.（2）Theresectionrateofcalcaneusheightandwidthintheobservationgroupwassignificantlybetterthanthatinthecontrolgroup.（3）TheMarylandfootscoreoftheobservationgroupwassignificantlybetterthanthatofthecontrolgroup（P<0.05）.（4）Thescoresofthequalityoflifeinthetwogroupsweresignificantlyimprovedafternursingintervention.Andthescoresoftheobservationgroupweresignificantlyhigherthanthoseofthecontrolgroup（P<0.05）.ConclusionContinuepassivemotioncombinedwithrehabilitationnursingiseffectiveinthetreatmentofintraarticularcalcanealfracturepatientswhoundergotheapproachofcalcaneallateralwallflaposteotomy，whichcanobtainsatisfactoryreductionandeffectivelyreducetheoccurrenceofsofttissuecomplications...