人工全膝关节置换术围手术期护理研究

Perioperative nursing total knee arthroplasty patients

目的探讨人工全膝关节置换术围手术期的护理方案,以有效提高患者术后恢复效果和生活质量,缩短住院时间。方法将2015年4月—2016年4月行人工全膝关节置换术的80例患者,按随机数字表法分为实验组和对照组,对应随机数字为奇数者为实验组,偶数者为对照组,每组40例。对照组给予常规护理,实验组给予围手术期全面护理,对2组患者进行术后疼痛情况和术后2周、1个月、3个月及6个月HSS评分;比较2组患者术后膝关节屈曲度恢复至≥90°所需时间和术后住院时间的差异。结果实验组患者术后6 h、12 h、24 h的疼痛VAS评分低于对照组,差异具有统计学意义(P<0.05);关于患者术后膝关节屈曲度恢复至≥90°所需时间和患者手术后住院时间,实验组均小于对照组,且差异具有统计学意义(P<0.05);HSS评分方面,2组患者术后2周、1月、3月及6个月HSS评分均呈不同程度提高,差异具有统计学意义(P<0.05)。结论加强人工全膝关节置换术围手术期护理能有效减少患者术后疼痛情况,提高患者术后恢复效果,缩短术后患者住院时间,提高了患者的生活质量和健康水平,对医院骨科手术护理的发展有重要意义。

Objective To study the perioperative nursing plan of total knee arthroplasty, so as to improve effectively the postoperative recovery and life quality of patients, and shorten the length of hospital stay. Methods Total 80 patients undergoing total knee arthroplasty in our department of between April ,2015 and April ,2016 were divided into experimental group and control group according to random number table with 40 cases in each group. The control group was given the routine nursing care, while the experimental group was given a comprehensive perioperative nursing. The postoperative pain and the hospital for special surgery（HSS） score at 2 weeks, 1 month ,3 months and 6 months after the operation were recorded in both groups;the time for patients to achieve more than 90 degree knee flexion and postoperative hospital stay were compared between the two groups. Results The pain visual analog scale （VAS） score at postoperative 6 h, 12 h and 24 h in the experimental group was lower than that in the control group, the difference was statistically significant （ P 〈 0.05 ） ; The time for patients to achieve more than 90 degree knee flexion and postoperative hospital stay in the experimental group were all less than those in the control group ,the difference was statistically significant（ P 〈0.05 ）. HSS score at 2 weeks ,1 month,3 months and 6 months after the operation in both groups were improved, however, the difference be- tween the two groups was statistically significant （ P 〈 0.05 ）. Conclusion The high-quality care for the total knee arthroplasty patients can effectively reduce postoperative pain, shorten the length of hospital stay, and improve the postoperative recovery and quality of life of patients,which has important significance on the development orthopedic surgery nursing.