智能关节康复器辅助压力充气泵对全膝关节置换术后患者功能恢复的影响

Effect of continuous passive motion combined with intermittent pneumatic compression on functional recovery of patients after total knee arthroplasty

目的:分析智能关节康复器辅助压力充气泵对全膝关节置换术(TKA)后患者功能恢复及预防深静脉血栓形成(DVT)的应用效果。方法:选择2019年6月至2020年12月在福建医科大学附属龙岩第一医院骨科行TKA的84例患者,随机分为观察组(n=42)和对照组(n=42)。对照组采用智能关节康复器结合常规康复护理的疗法,观察组在对照组的基础上联合间歇性压力充气泵的疗法。在治疗期间观察与记录两组患者的DVT情况(下肢静脉流速、术后DVT发生率以及静脉血栓直径),抗凝药物使用率、血液流变学指标、膝关节屈伸活动度(ROM)、生活质量量表-74(GQOL-74)以及护理服务的满意度情况。结果:观察组DVT发生率、抗凝药物使用率均低于对照组(P<0.05),同时下肢深静脉流速大于对照组(P<0.05),DVT直径小于对照组(P<0.05)。术后1 d,两组患者的ROM比较,差异无统计学意义(P>0.05)。术后7、14 d,两组患者的ROM均显著大于术后1 d的ROM(P<0.05),且观察组的ROM明显大于对照组(P<0.05)。干预后,两组血液流变学指标显著小于干预前(P<0.05),且观察组均显著小于对照组(P<0.05)。干预后,两组的GQOL-74评分均显著高于干预前(P<0.05),且观察组高于对照组(P<0.05)。观察组的护理干预满意度为95.24%,明显高于对照组的80.95%(P<0.05)。结论:智能关节康复器辅助压力充气泵对TKA术后患者可以改善血液流变学指标,降低抗凝药物使用率,有效预防下肢DVT,提高患者生活质量和满意度。

Objective To analyze the effect of continuous passive motion combined with intermittent pneumatic compression on functional recovery and prevention of deep vein thrombosis(DVT)in patients after total knee arthroplasty(TKA).Methods A total of 84 patients who underwent TKA in the Department of Orthopedics,Longyan First Hospital,Fujian Medical University from June 2019 to December 2020 were enrolled and randomly divided into observation group(n=42)and control group(n=42).Control group was treated with continuous passive motion and routine nursing,while observation group received intermittent pneumatic compression besides those treatments in control group.During the treatment,DVT status(lower extremity venous flow velocity,postoperative DVT incidence and venous thrombus diameter)was analyzed;and the usage rate of anticoagulants,hemorheological indexes,range of motion(ROM),generic quality of life inventory-74(GQOL-74)and patient satisfaction with nursing services were recorded.Results Compared with control group,observation group had lower incidence of DVT and usage rate of anticoagulants(P<0.05),greater deep venous flow velocity of the lower limbs(P<0.05)and smaller DVT diameter(P<0.05).On the 1st day postoperatively,there was no statistical difference in ROM between two groups(P>0.05).On days 7 and 14 after surgery,the ROM of patients in both groups was greater than that on day 1 after surgery(P<0.05),and the ROM of observation group was larger than that of control group(P<0.05).The intervention in both groups resulted in lower hemorheological indexes(P<0.05)and higher GQOL-74 scores(P<0.05)as compared with those before intervention;and after intervention,observation group had lower hemorheological indexes and higher GQOL-74 scores than control group(P<0.05).The degrees of satisfaction with nursing intervention in observation group and control group were 95.24%and 80.95%(P<0.05).Conclusion The combination of continuous passive motion and intermittent pneumatic compression for patients after TKAcan improve hemorheological indexes,reduce the use of anticoagulants,effectively prevent lower limb DVT,and improve patients'quality of life and satisfaction.