,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Company Logo,LOGO,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Company,Logo,人工髋关节置换,术后,康复,锻炼,中南大学湘雅三医院 成湘红,Company,Logo,Company,Logo,康复的目的,1、保证和稳固手术治疗效果。,2、恢复被破坏的关节功能，维持关节的稳定性和骨的负 重能力。,3、增强关节周围的肌群力量，防止肌肉萎缩，减少和消 除并发症的发生和开展。,4、提高生活质量。,骨科康复评定,肌力评定,关节活动度测定,步态分析检查,感觉功能评定,疼痛的评估,日常生活能力的评估,Company,Logo,人工髋关节置换是指用金属、高分子聚乙烯、陶瓷等材料，根据人体髋关节的形态、构造及功能制成人工关节假体，通过外科手术植入人体内，代替患病关节功能，到达缓解关节疼痛，恢复关节功能的目的。,人工髋关节置换的定义,适应证,1.,陈旧性股骨颈骨折，退行性骨关节炎等疾病导致的股骨头或髋臼破坏。,2.,炎症、结核、肿瘤等疾病导致髋关节骨质破坏，髋关节疼痛。,3.,各种原因导致的股骨头缺血性坏死，慢性或先天性髋关节脱位及先天性髋臼发育不良。,Company,Logo,手术仅完成了解剖对位，术后科学的功能锻炼才能保证手术的质量。,原那么：个体化、循序渐进、全身锻炼。,伸直双下肢，双踝放松，先做足部,背伸动作，背伸时要到达最大限度，,坚持5秒，然后从背伸状态开始做,跖屈，坚持5秒，跖屈也要到达最,大限度。,功能锻炼,一、踝泵运动和踝关节旋转运动,踝关节向内及向外旋转练习，每个方向,20,次。,目的：通过活动踝关节，促进患肢血液循环，防止血液瘀滞，锻炼小腿肌群,。,二、股四头肌功能锻炼,尽量伸直膝关节，收缩大腿肌肉，保持,5,秒，再放松,2,秒，反复练习，直到大腿感觉到疲劳为止。,目的：训练,股四头肌,的力量，因为,股四头肌,是关节伸直的主要力量，同时具有伸膝屈髋，维持人体直立姿势的功能。,足跟部向臀部缓慢移动并弯曲膝关节，注意髋关节屈曲小于,45,，并使足底不离开床面，保持,5,秒，再缓慢伸直。下肢不可内旋，,不可过度屈髋,。,目的：活动髋关节，防止关节僵化。,术后第二、三天,一、贴床屈膝运动,以被动直腿抬高训练为主：收缩大腿肌肉，尽量伸直膝关节，抬高足部并使其离床,10,20,厘米，持续,5,秒，慢慢放低，重复练习直到大腿感到疲劳为止。,二、直腿抬高运动,术后第三到七天,先摇高床头，利用双上肢 和健肢支撑力将身体移至健侧床旁,扶患者坐起，健侧先离床并使足部着地，然后患肢离床。上床时按相反方向进行。,一、离床训练,二、借助助行器行走,将助行器放在健侧腿,旁，向床边移动身体。,将健侧腿移到床下，,防止术侧髋外旋。,术侧腿顺势移到床下，将身体转正，扶助行器站立。,助行器摆在身前,20cm,，,先迈术侧腿，,再将健侧腿跟上。,术后步行训练遵循助行器,-,扶双拐,-,扶单拐,-,扶手杖,-,脱手杖循序渐进，直至完成步行、快走。,三、如何站立,从椅子上站起,身体首,先挪到椅子旁,患肢放,在前面,健侧腿承受大,局部体重。,坐下之前做好准备，需要有靠背和扶手的椅子，加坐垫，倒退，看好位置，双手扶稳，缓缓坐下。,屈髋不能小于,90,，,要坐较高的椅子。,四、如何坐位,术后二周后,二周内继续稳固以往的训练效果，提高日常生活自理能力。二周后如果假体固定方式是水泥型的，固定比较牢固，患肢可逐渐弃拐负重行走；如果假体固定方式是生物型的，患肢需拄拐2 3月固定牢固后才能弃拐逐渐负重行走。,X,ie,X,ie,谢谢！,Company,Logo,