关节镜下自体腘绳肌腱鞘内重建膝前交叉韧带18例围术期康复护理

Perioperative rehabilitation nursing in the treatment of 18 patients by intrathecal reconstruction of ACL of knee with autografts of hamstring tendon under arthroscope

目的：对膝前交叉韧带（ACL）损伤患者在关节镜下行自体胭绳肌腱鞘内重建术，探讨在围术期加强康复护理效果。方法：对18例ACL损伤患者术前做好心理护理、肌力锻炼，加强患者战胜疾病的信心；术后对患肢使用支具固定，弹力绷带包扎，冰袋外敷以减轻局部充血肿胀，减轻疼痛，早期进行患肢功能锻炼，防止发生废用综合征，促进膝关节的主动与被动运动，做好出院访视，有效跟踪患者的康复情况。结果：本组患者患膝术后肿胀均在2～4周内消退，均未出现关节内感染、神经血管损伤及滑膜炎等并发症；患肢股四头肌无萎缩现象。本组患者术前及术后15个月Lysholm评分比较差异有统计学意义（P〈0．05）。结论：对ACL损伤行关节镜下自体胭绳肌腱鞘内重建术的患者加强围术期康复护理，可促使患者更快、更好地恢复正常的关节功能。

Objective：To investigate the effect of perioperative rehabilitation nursing in the treatment of patients by intrathecal recon- struction of anterior cruciate ligament （ ACL ） of knee with autografts of hamstring tendon under arthroscope. Methods ： The comprehensive perioperative nursing care was provided for 18 patients who suffered ACL injuries, including preoperative psychological care, muscle strength exercise, strengthening the confidence to fight the disease, postoperative limb fixation, elastic bandaging, ice compress to relieve lo- cal congestion and swelling, relieving pain, early function exercise, discharge visits, etc.. Results ： The knee swelling reduced in 2 - 4 weeks after surgery. No complications like intra - articular infection, neurovascular injury and synovitis occurred and no occurrence of atrophy of quadrieeps femoris of the affected limb. The comparison of Lysholm score was significantly different before operation and after operation for 15 months （ P 〈 0.05 ）. Conclusion ： The strengthened perioperative rehabilitation nursing can promote the patient＇s restoration of joint func-tion in the treatment of ACL injuries by intratheeal reconstruction of ACL of knee with autografts of hamstring tendon under arthroseope.