全膝关节置换术后膝关节肿胀、疼痛程度对膝关节功能的影响及护理

Knee joint function effect and nursing on knee swelling and pain after total knee replacement surgery

目的探讨全膝关节置换术后膝关节肿胀、疼痛程度对膝关节功能的影响,评价护理干预对全膝关节置换术患者的临床疗效。方法选取我院2008年1月～2011年6月采用全膝关节置换术治疗的患者122例,随机分为两组,采用全膝关节置换术联合常规护理治疗的患者为对照组(61例),在对照组治疗基础上采用健康教育、心理护理、综合功能锻炼等护理干预配合治疗的患者为观察组(61例)。分别比较两组患者术后第1天、第3天、第7天的膝关节肿胀和疼痛程度,术后治疗2周后对所有患者进行美国膝关节学会评分(AKSS)、膝关节活动范围(ROM)、视觉模拟评分(VAS)。结果在术后第1天、第3天、第7天观察组膝关节屈曲度数明显大于对照组(P<0.05);无论是对照组还是观察组,患者在第3天膝关节肿胀和疼痛程度最为严重;在术后第1天、第3天、第7天观察组膝关节肿胀人数和疼痛人数均明显少于对照组(P<0.05),观察组AKSS评分和VAS评分明显高于对照组,而ROM评分明显低于对照组,差异有统计学意义(P<0.05)。结论全膝关节置换术后膝关节肿胀、疼痛程度对膝关节功能恢复有一定影响,膝关节肿胀、疼痛程度越严重恢复越慢,做好消除肿胀和疼痛的护理,预防静脉血栓的形成,及时补充营养,同时采取有效的综合护理干预可以提高患者术后的膝关节功能恢复效果,是一种安全有效的治疗方法,值得临床推广使用。

Objective To investigate knee joint function effect on knee swelling and pain after total knee replacement surgery and clinical effect of nursing on total knee replacement surgery.Methods 122 patients were selected in our hospital from January 2008 to June 2011 after total knee arthroplasty in treatment,who were randomly divided into two groups.61 patients used routine care in treatment and total knee replacement as a control group.Basing on the control group treatment,61 patients used health education,psychological care,comprehensive nursing interventions as a observatiton group.Knee joint swelling and pain of two groups were respectively compared with postoperative 1th day,3rd day and 7th day.AKSS,ROM,VAS were used for all patients after 2 weeks postoperative treatment.Results After operation 1th day,3rd day,7th day,knee buckling degrees in the observation group were obviously greater than the controlled group（P 0.05）.Either the control group or the observation group,knee swelling and pain degree of patients in the 3rd day were most serious.After operation 1th day,3rd day,7th day knee swelling number and pain number in the observation group were obviously less than that of the control group（P 0.05）.AKSS scoring and VAS scoring in the observation group were obviously higher than of the control group,ROM scoring in the observation group was obviously lower than the control group,there were significant differences（P 0.05）.There was statistics significance.Conclusion Knee swelling and pain degree after full knee replacement operation has must effect on knee function recovery.When knee swelling,and pain degree are more serious,recovery is a more slow.Elimination swelling and pain of nursing must be done.Nutrition is timely supplementary for the prevention vein thrombosis of formed.Taking effective integrated nursing intervention can improve knee function recovery effect after operation.That is a security effective of treatment method,which is worth clinical promotion using.