人工髖關節置換術，病人術後關節功能與生活品質追蹤研究

Follow-Up Study of Joint Function and Quality of Life in Patients After Total Hip Arthroplasty

背景：隨著人口高齡化，退化性關節炎病人逐漸增加，嚴重關節病變須接受人工髖關節置換術，醫療院所壓縮住院天數，術後關節功能狀態與生活品質值得關切。目的：（1）追蹤人工髖關節置換術病人手術前後髖關節功能、下肢功能、與健康有關生活品質變化情形。（2）人口學基本資料與髖關節功能、下肢功能、與健康有關生活品質之相關性。方法：本研究採縱貫研究法，採方便取樣，共收案30位第一次接受人工髖關節置換術病人，於病人手術前、手術後2週、手術後6週、手術後3個月收集病人資料。結果病人於手術後2週下肢功能與健康有關之生活品質均較手術前顯著較差（p＜.05）；手術後6週及3個月在髖關節功能、下肢功能、與健康有關之生活品質均較手術前顯著改善（p＜.05）。男性病人在髖關節功能、下肢功能、與健康有關之生活品質較女性病人佳（p＜.05）；年紀輕者下肢功能較佳（p＜.05）；有工作者、與家人同住者在髖關節功能、下肢功能、與健康有關之生活品質比無工作者佳（p＜.05）、獨居者佳（p＜.05）。有無共病在髖關節功能、下肢功能、與健康有關之生活品質的得分均無顯著差異（p＞.05）。結論：研究結果可做為臨床護理人員提供人工髖關節置換術病人術前及術後照護之參考。

Background: The number of patients with osteoarthritis has gradually increased with population aging. Total hip replacement is typically required in patients with severe arthritis. Because hospitals are reducing the allowable length of hospital stays, joint function recovery and quality of life after surgery are issues of increasing concern in this population. Purposes: 1. To track changes in hip function, lower limb function, and health-related quality of life before and after total hip replacement surgery. 2. To examine the correlation between basic demographic data and hip function, lower limb function, and health-related quality of life. Methods: A longitudinal study with convenient sampling was used. Thirty patients undergoing primary total hip arthroplasty were recruited. Data were collected before the operation and at two weeks, six weeks, and three months after the operation. Results: The results were as follows. (1) At two weeks after the operation, lower limb function and quality of life were significantly worse than before the operation (p < .05). At six weeks and three months after surgery, hip function, lower extremity function, and health-related quality of life were significantly better than before the operation (p < .05). Male patients had better hip function, lower extremity function, and health-related quality of life than female patients (p < .05). Younger people had better lower limb function (p < .05). Those who had jobs and lived with their families had better hip function, lower limb function, and health-related quality of life than those without jobs (p < .05) and those living alone (p < .05). No significant correlation was found between the comorbidities and hip function, lower limb function, or health-related quality of life (p > .05). Conclusions: The results may be used as a reference for clinical nurses providing preoperative and postoperative care to patients undergoing total hip arthroplasty.