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| 1例PPRD患者双髋置换术后“自由体位”循证护理 |
| A case of evidence-based nursing for free position after bilateral total hip arthroplasty in a patient with progressive pseudorheumatoid dysplasia |
| 投稿时间：2026-04-02 修订日期：2026-06-17 |
| DOI： |
| 中文关键词: 进行性假性类风湿性发育不良 直接前入路 全髋关节置换术 自由体位 循证护理 |
| 英文关键词:progressive pseudorheumatoid dysplasia direct anterior approach total hip arthroplasty free position evidence-based nursing |
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| 中文摘要: |
| 总结1例进行性假性类风湿性发育不良患者行分期双侧直接前入路全髋关节置换术的围术期护理经验。在骨折联络服务多学科团队协作下，针对患者双髋强直、肌肉萎缩等特点，实施以“自由体位”为核心，配合超早期分级康复、阶梯式静脉血栓栓塞症防控及动态安全监测的个体化护理方案。患者未发生假体脱位、深静脉血栓等并发症；术后24h内助行器下床，3天双髋屈曲达70°；Harris髋关节评分由术前26分升至出院时72分。本案例形成的“FLS协作-自由体位-早期康复-动态防控”结构化护理模式，为此类罕见病加速康复提供了临床路径。 |
| 英文摘要: |
| This paper summarizes the perioperative nursing experience of a patient with progressive pseudorheumatoid dysplasia (PPRD) who underwent staged bilateral total hip arthroplasty via the direct anterior approach (DAA). Under the collaboration of a multidisciplinary Fracture Liaison Service (FLS) team, an individualized nursing plan was implemented based on the patient’s characteristics, including bilateral hip ankylosis and muscle atrophy. The plan centered on "free positioning," combined with ultra-early progressive rehabilitation, stepped venous thromboembolism (VTE) prevention, and dynamic safety monitoring. No complications such as prosthetic dislocation or deep vein thrombosis occurred. The patient achieved ambulation with a walker within 24 hours after surgery, and bilateral hip flexion reached 70° by postoperative day 3. The Harris Hip Score improved from 26 preoperatively to 72 at discharge. The structured nursing model developed in this case—"FLS collaboration–free positioning–early rehabilitation–dynamic prevention and monitoring"—provides a clinical pathway for enhanced recovery in such rare disorders. |
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