改良三联术治疗复发性髌骨脱位的围术期护理

Perioperative Nursing on Modified Triple Surgery in Treating Recurrent Patellar Dislocation

目的探讨改良三联术治疗髌骨脱位患者围术期的护理措施。方法对2008年11月至2010年1月收治的65例复发性髌骨脱位患者采用改良三联手术治疗,术前行心理护理,术后采取持续的、渐进式的功能康复锻炼,评价患者手术前后的膝关节功能（包括Q角、Kujala评分、Lysholm膝关节评分等）。结果随访时间9~18个月,平均13个月;术前、后平均Q角分别为（20.7±4.3）°和（10.1±2.2）°,Kujala评分分别为（60.7±7.1）和（83.5±8.1）分,Lysholm膝关节评分分别为（51.9±7.3）和（92.5±3.4）分,差异均有统计学意义（P〈0.01）。结论围术期针对性的护理和康复指导可以有效提高患者的主观能动性,使其积极进行康复训练,从而促进患者膝关节功能的恢复、提高治疗效果。

Objective To investigate the perioperative nursing measures on recurrent patellar dislocation treated with modified triple surgery.Methods From November 2008 to January 2010,65 patients with recurrent patellar dislocation were treated with modified triple surgery in our hospital.Preoperative psychological care and postoperative continuous,progressive functional rehabilitation exercises were conducted.The knee function was evaluated by Q angle,Kujala score,Lysholm knee score before surgical treatment and final follow-up time,separately.Results All the patients were followed up for 9 to 18 months,with an average of 13 months.The Q angle was（20.7±4.3）° preoperatively and（10.1±2.2）° postoperatively.The Kujala score was 60.7±7.1 preoperatively and 80.53±83.5 postoperatively.The Lysholm knee score was 51.9±7.3 preoperatively and 92.5±3.4 postoperatively.There were statistical differences between preoperative and postoperative scores（P0.01）.Conclusion Perioperative nursing and rehabilitation guidance can improve the patient＇s initiative of active functional exercises,effectively restore knee function and improve treatment effectiveness.