基于多元化康复模式的护理干预对胫骨平台骨折患者膝关节功能恢复及生活质量的影响

Effects of nursing intervention based on diversified rehabilitation patters on function recovery of knee joint and life quality of patients with tibial plateau fractures

目的探讨基于多元化康复模式的护理干预对胫骨平台骨折患者膝关节功能恢复及生活质量的影响。方法选取2013年9月至2016年9月确诊治疗的胫骨平台骨折患者120例,依据随机数表法随机分为多元化组和常规组,每组60例。常规组患者给予常规康复护理干预,多元化组患者在此基础上给予基于多元化康复模式的护理干预,采用视觉模拟评分法(VAS)评估疼痛程度,采用自制《胫骨平台骨折疾病及其康复知识问卷》评估疾病康复知识掌握程度,采用Lysholm膝关节评分量表评估膝关节功能,采用日常生活能力量表(ADL)评估生活质量,随访6个月,采用logistic回归性分析法分析患者生活质量的独立影响因素,统计分析所有患者疾病康复知识掌握程度,干预前、干预后1、3、6个月的疼痛,膝关节功能及生活质量恢复情况。结果多元化组患者疾病康复知识掌握率明显高于常规组,差异有统计学意义(P<0.05);多元化组患者干预后1、3、6个月VAS得分明显低于常规组,差异有统计学意义(P<0.05);多元化组患者干预后1、3、6个月的Lysholm得分明显高于常规组,差异有统计学意义(P<0.05);多元化组患者干预后1、3、6个月ADL得分明显高于常规组,差异有统计学意义(P<0.05);Logistic回归性分析法结果显示,疾病康复知识掌握程度、疼痛程度、膝关节功能是患者生活质量的独立影响因素(P<0.05)。结论基于多元化康复模式的护理干预可有效提高胫骨平台骨折患者的疾病康复知识掌握程度,可有效改善患者的疼痛症状和膝关节功能恢复,有利于提高患者的生活质量及减少其独立影响因素的不良影响,值得临床作进一步推广。

Objective To investigate the effects of nursing intervention based on diversified rehabilitation patters on function recovery of knee joint and life quality of patients with tibial plateau fractures. Methods A total of 120 patients with tibial plateau fractures who were definitely diagnosed and treated in our hospital from September 2013 to September 2016 were randomly divided into diversification nursing group and conventional nursing group,with 60 patients in each group. The patients in conventional nursing group were treated by conventional rehabilitation nursing intervention,however,the patients in diversification nursing group,on the basis of conventional nursing group,were treated by versified rehabilitation nursing intervention,then patient＇s pain degree was assessed according to visual analogue scale（ VAS）,and the grasping degree for disease rehabilitation knowledge was evaluated according to self-made 《Questionnaire about tibial plateau fractures and rehabilitation knowledge》,and knee joint function was evaluated according to Lysholm knee rating scale,moreover patient＇s life quality was assessed according to daily life ability scale（ ADL）. Moreover these patients were followed up for 6 months,the independent influencing factors of life quality,patient＇s grasping degree for rehabilitation knowledge,the recovery state of knee joint function and life quality before intervention and on 1 m,3 m,6 m after intervention were statistically analyzed by means of Logistic regression analysis. Results The rehabilitation knowledge grasping rate in diversification nursing group was significantly higher than that in conventional nursing group（ P〈 0. 05）,and the VAS scores on 1 m,3 m,6 m after intervention in diversification nursing group were significantly lower than those in conventional nursing group（ P〈 0. 05）. However Lysholm scores on 1 m,3 m,6 m after intervention in diversification nursing group were significantly higher than those in conventional nursing group（ P 〈0. 05）,moreover,the ADL scores on 1 m,3 m,6 m after intervention in diversification nursing group were significantly higher than those in conventional nursing group（ P〈 0. 05）. Besides the Logistic regression analysis showed that the patient＇s grasping degree for rehabilitation knowledge,pain degree and knee joint function were independent influencing factors on life quality of patients（ P〈 0. 05）. Conclusion The nursing intervention based on diversified rehabilitation patters can effectively improve grasping degree for rehabilitation knowledge in patients with tibial plateau fractures,which can effectively improve patient＇s pain symptoms and knee joint functional recovery,moreover,which is benefit to increase patient＇s life quality and decrease the impact of independent influencing factors,thus,which is worth using widely in clinical practice.