模块式康复训练联合情志护理对胫骨平台骨折患者膝关节恢复及精神状态的影响

The Influence of Modular Rehabilitation Training Combined with Emotional Care on Knee Joint Recovery and Mental State of the Patients with Tibial Plateau Fracture

目的:探究模块式康复训练联合情志护理对胫骨平台骨折患者膝关节恢复及精神状态的影响。方法:将60例患者按就诊的先后顺序随机分为观察组、对照组各30例。对照组予以常规术后护理,观察组在对照组护理干预的基础上予以模块式康复训练联合情志护理。干预前及干预后第4、8周,根据美国特种外科医院的膝关节功能评分表(HHS)对患者膝关节功能进行评分,观察HHS的变化情况及出院时HHS评分等级。在护理干预前后,分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估患者精神状态。结果:HHS评分干预后4、8周与干预前2组组内比较,差异有统计学意义(P<0.05);干预后8周与干预后4周2组组内比较,差异有统计学意义(P<0.05);干预后同期2组组间比较,差异也有统计学意义(P<0.05)。出院时HHS评分等级优良观察组为93.3%,对照组为73.3%,2组比较差异有统计学意义(P<0.05)。HAMA及HAMD评分干预前后2组组内比较,差异有统计学意义(P<0.05);干预后2组组间比较,差异也有统计学意义(P<0.05)。结论:模块式康复训练联合情志护理能有效促进胫骨平台骨折患者膝关节恢复,有效改善患者精神状态。

Objective： To discuss the effects of modular rehabilitation training in combination with emotional care on mental state and knee joint recovery of the patients with tibial plateau fracture. Methods： Sixty patients were allocated to the observation group and the control group according to the visiting order, 30 cases each group. The control group accepted routine postoperative care, and the observation group modular rehabilitation training in combination with emotional care based on nursing intervention. The changes of HHS and its changes before and after nursing intervention when discharged were observed after knee joint functions of the patients were scored according to HHS before the intervention, at the forth week and the eighth week after the intervention, HAMD and HAMA were used to assess mental state of the patients respectively. Results： When HHS scores at the forth week and the eighth week after the intervention were compared with these before the intervention within two groups, the difference had statistical meaning（P〈0.05）; when HHS scores at the eighth week after the intervention were compared with these at the forth week after the intervention within two groups, the difference had statistical meaning（P〈0.05）;when HHS scores were compared between both groups after the intervention at the same period, the difference was statistically significant（P〈0.05）. The excellent rate of HHS scores in the observation group was 93.3%, higher than73.3% of the control group when the patients were discharged from hospital, and the difference had statistical meaning（P〈0.05）. When HAMA and HAMD scores were compared before and after the intervention within two groups, the difference had statistical meaning（P0.05）; when they were compared between both groups after the intervention,the difference had statistical meaning（P 〈0.05）. Conclusion： Modular rehabilitation training in combination with emotional care could effectively promote knee joint recovery of the patients with tibial plateau fracture, improve their mental state.