基于德尔菲法制订早期下床活动策略在促进中老年全膝关节置换术患者康复中的应用

Application of Early Ambulation Strategy Based on Delphi Method in Promoting the Rehabilitation of the Middle-aged and Old Patients with Total Knee Arthroplasty

目的:探讨基于德尔菲法制订早期下床活动策略在促进中老年全膝关节置换术(TKA)患者康复中的应用效果。方法:随机选取中老年TKA患者110例为研究对象,按照随机数字表法分为观察组和对照组各55例;对照组采取常规护理及术后康复指导,观察组在对照组基础上采取基于德尔菲法制订的早期下床活动策略护理干预。比较干预1、3、7 d两组关节疼痛评分[采用视觉模拟评分法(VAS)],干预1 d、1周及1个月后关节活动度(ROM),干预2个月后患者膝关节功能及生活质量。结果:与术后1 d比较,术后3、7 d两组VAS评分均降低(P<0.05),且干预后各时间点组间比较差异有统计学意义(P<0.05);与术后1 d比较,术后1周、术后1个月后两组ROM值均升高(P<0.05),且干预后各时间点组间比较差异有统计学意义(P<0.05);干预3个月后,两组美国特种外科医院膝关节功能评分表(HSS)、Lysholm膝关节功能评分表、生活质量综合评定量表(GQOLI-74)评分均升高(P<0.05),且干预后组间比较差异有统计学意义(P<0.05)。结论:基于德尔菲法制订早期下床活动策略有助于加快TKA患者术后恢复速度,改善膝关节功能,提高生活质量。

Objective:To explore the application effect of early ambulation strategy based on Delphi method in promoting the rehabilitation of the middle-aged and old patients with total knee arthroplasty(TKA).Methods:A total of 110 patients with senile TKA were randomly selected as the research objects,according to the random number table method were divided into the observation group and the control group with 55 cases in each group;The control group adopted routine nursing and postoperative rehabilitation guidance,while the observation group on the basis of the control group adopted early ambulation strategy based on Delphi method nursing intervention.Comparison was made between the two groups after intervention on 1,3,and 7 d on joint pain scores by using visual analogue scale(VAS),joint motion(ROM)1 d,1 week and 1 month after the intervention,knee joint function and quality of life after 2 months.Results:Compared with the postoperative 1 d,the 3 and 7 d postoperative VAS scores were lower in both groups(P<0.05),and with significant differences between the two groups at each time point after the intervention(P<0.05);Compared with the postoperative 1 d,the postoperative 1 week and 1 month the ROM values increased in both groups(P<0.05),and with significant differences between the two groups at each time point after the intervention(P<0.05);and after the intervention group at each time point between the comparative difference was statistically significant(P<0.05);Intervention after 3 months,the American hospital for special surgery(HSS)scale,Lysholm knee joint function scale and quality of life rating scale(GQOLI-74)scores were higher(P<0.05),and after the intervention with significant differences between both groups(P<0.05).Conclusion:Early ambulation strategy based on Delphi method can help to speed up the postoperative recovery in TKA patients,improve their function of knee joint,and improve their quality of life.