协同护理模式联合CPM对高龄膝关节置换术后患者功能康复的影响

Effect of CCM combined with CPM on function rehabilitation of elderly patients after TKA

目的:观察协同护理模式(CCM)联合连续被动膝关节训练器(CPM)对75岁以上全膝关节置换术(TKA)后患者的膝关节功能康复的影响。方法:选取2017年1月至2019年5月在川北医学院第二临床医学院骨科行单侧TKA的114例患者,其中对照组(n=57)给予传统康复护理,干预组(n=57)给予CCM联合CPM训练。将膝关节活动度(ROM)、关节功能评分量表(HSS)评分和日常活动能力量表(ADL)评分作为膝关节功能恢复效果的评价指标。观察时间点设定为术后1个月、2个月、3个月及6个月,比较两组患者术后各个时间点膝关节活动功能的恢复效果。术后3个月及6个月,比较两组患者全血中性粒细胞、淋巴细胞、血沉和超敏C反应蛋白(CRP)的结果。结果:术后1个月、2个月、3个月及6个月,干预组ROM、HSS评分和ADL评分均明显优于对照组(P<0.05)。术后3个月及6个月,两组全血中性粒细胞、淋巴细胞、血沉和CRP比较,差异均无统计学意义(均P>0.05)。结论:CCM联合CPM对75岁以上的高龄TKA术后患者的膝关节功能恢复产生了良好的效果,能提高患者术后满意度。

Objective:To observe the effect of collaborative care model(CCM)combined with continuous passive motion(CPM)on knee function rehabilitation of patients over 75 years old after total knee arthroplasty(TKA).Methods:Total of 114 patients who underwent unilateral TKA in Orthopedics Department of the Second Clinical Medical College of North Sichuan Medical College from Jan.2017 to May.2019 were selected.The control group(n=57)were given traditional rehabilitation care and the intervention group(n=57)were given CCM combined with CPM training.Range of motion(ROM),joint function score,and daily mobility score were used as evaluation indicators of knee joint function.The observation time point was set as 1 month,2 months,3 months and 6 months after operation,and the recovery effect of knee joint function at each time point was compared between the two groups.The results of whole blood neutrophils,lymphocytes,erythrocyte sedimentation and high-sensitivity C-reactive protein(CRP)were compared between the two groups in observation time point of 3 and 6 months.Results:ROM,joint function score,and daily mobility score of the intervention group were all significantly better than the control group at each time point(P<0.05).ROM of the knee joint in the intervention group was higher than that in the control group at 1 month,2 months,3 months,and 6 months after operation,the differences were statistically significant(P<0.05).The knee function scores of the intervention group at 1 month,2 months,3 months,and 6 months after operation were all higher than those of the control group,and the differences were statistically significant(P<0.05).The daily mobility scores of the intervention group at 1 month,2 months,3 months,and 6 months were all lower than those of the control group,and the differences were statistically significant(P<0.05).At 3 and 6 months after operation,there were no significant differences in whole blood neutrophils,lymphocytes,erythrocyte sedimentation and CRP between the two groups(all P>0.05).Conclusion:CCM combined with CPM has a good effect on knee function rehabilitation in patients over 75 years old after TKA,and can improves the postoperative satisfaction of patients.