人工全膝关节置换术术中护理效果及HSS评分、并发症情况的分析

Analysis on nursing effect and HSS score and complications of total knee arthroplasty

目的探讨人工全膝关节置换术术中护理效果及对HSS评分和并发症的影响。方法选取2013年3月-2015年3月于该院实施人工全膝关节置换术的患者100例。采用随机分组原则分为研究组和对照组，各50例。研究组术中予以针对性手术室护理，对照组予以常规护理。观察术后VAS评分、HSS评分、Katz评分及切口愈合情况和术后并发症情况，同时观察两组患者术后膝关节屈曲度≥90度所需要的时间及住院时间，综合评价两组患者术后临床恢复优良率及护理效果。结果两组患者术后6hVAS评分比较，差异无统计学意义（P〉0．05），而术后24hVAS评分比较，研究组显著低于对照组，差异有统计学意义（P〈0．05）；术后切口愈合良好率分析，术中予以针对性护理手术配合的患者明显优于常规护理组，差异有统计学意义（P〈0．05）；术后2周、1个月、3个月患者HSS评分比较，研究组显著高于对照组，差异均有统计学意义（均P〈0．05）；研究组术后膝关节屈曲度≥90度所需要的时间及住院时间显著短于对照组，差异均有统计学意义（均P〈0．05）；临床恢复优良率比较，组间比较，差异无统计学意义（P〉0．05）；而研究组护理有效率及Katz评分显著高于对照组，差异均有统计学意义（均P〈0．05）。此外，研究组术后并发症发生率低于对照组，组间比较，差异有统计学意义（P〈0．05）。结论人工全膝关节置换术中根据手术操作需求实施针对性护理干预，可显著改善术后HSS评分，缩短住院时间，并有效避免并发症，值得临床参考应用。

Objective To study the effects of total knee arthroplasty and its effects on HSS score and compli- cations. Methods A total of 100 patients who underwent total knee arthroplasty admitted to this hospital from March 2013 to March 2015 were selected. According to the random number table method, they were divided into the research group and the control group, 50 cases of each group. The research group was treated with targeted operation room nurs- ing. The control group was given the routine nursing. The postoperative VAS score, HSS score, Katz score, incision healing and postoperative complications were observed. At the same time, the time required for knee flexion greater than or equal to 90 degrees and the length of hospital stay were observed. The optimal rate of clinical recovery and nurs- ing effect of the two groups were comprehensively evaluated. Results There was no significant difference in VAS score at 6 hours after surgery, and the difference was not statistically significant （ P〉0. 05 ）. However, the VAS score at 24 hours after surgery was significantly lower in the research group than that in the control group, and the difference was sta- tistically significant （P〈0. 05）. The analysis of the good rate of postoperative wound healing showed that the patients who received targeted nursing during operation were significantly superior to the conventional nursing group, and the difference was statistically significant （P〈0. 05）. The HSS scores of the patients at 2 weeks, 1 month and 3 months after surgery in the research group were significantly higher than that in the control group, with statistically significant differences （P〈 0. 05）. The time and hospitalization time required for knee flexion greater than or equal to 90 degrees were significantly shorter in the research group than that in the control group, and the differences were statistically significant （P〈0. 05）. There was no statistically significant difference between the groups in the rate of clinical recovery （ P〉0. 05 ）. The effi- ciency and Katz scores of the research group were significantly higher than those of the control group, and the differences were statistically significant （P〈0. 05）. In addition, the incidence of postoperative complications in the research group was lower than that of the control group. And the difference was statistically significant （P〈0. 05）. Conclusions In to- tal knee arthroplasty, targeted nursing intervention can significantly improve the postoperative HSS score, shorten the length of hospital stay and effectively avoid complications. It is worthy of clinical reference and application.