同伴教育联合加速康复外科在TKA患者日常生活能力改善中的应用

Application of Peer Education Combined with Accelerated Rehabilitation Surgery in Improving Daily Living Ability of Patients with TKA

目的探讨同伴教育联合加速康复外科对全膝关节置换术后患者日常生活能力的影响。方法选取2015年3月～2018年3月我院收治的行人工膝关节置换患者80例,随机分为观察组和对照组,每组40例。两组患者均给予加速康复外科理念干预,观察组在此基础上结合同伴教育,两组患者均进行3个月干预治疗,采用HSS评分、膝关节活动范围、改良Barthel指数量表对所有患者术前、术后第1天、术后2周、术后3个月膝关节活动度及日常生活能力进行评估。结果两组患者术后2周、3个月HSS评分、ADL评分及膝关节活动度均较术前改善,差异均有统计学意义(P<0.05);与对照组相比,观察组术后2周、3个月HSS评分、ADL评分及膝关节活动度改善更明显,术后第1天、第2天、第3天疼痛程度均低于对照组,差异均有统计学意义(P<0.05);但两组患者术后并发症发生率无统计学意义(P>0.05)。结论同伴教育联合加速康复外科可更好改善TKA患者的膝关节功能及日常生活能力,利于其早日无障碍或少障碍的回归家庭和社会。

Objective To explore the effect of peer education combined with accelerated rehabilitation surgery on the daily living ability of patients after total knee arthroplasty. Methods 80 patients with artificial knee joint replacement admitted to our hospital from March 2015 to March 2018 were randomly divided into observation group and control group, 40 cases in each group. Both groups of patients were given the intervention of accelerated rehabilitation surgery. The observation group was combined with peer education. The two groups were treated with intervention for 3 months. All patients were treated with HSS score, knee range of motion, and modified Barthel index.The knee joint activity and daily living ability were evaluated on the first day after surgery, 2 weeks after surgery, and 3 months after surgery. Results The HSS score, ADL score and knee motion of the two groups were significantly improved 2 weeks and 3 months after operation,the differences were statistically significant( P<0.05). Compared with the control group, the HSS score, ADL score and knee joint activity improved significantly in the observation group at 2 and 3 months after operation. The first day and the second day after surgery were observed. The pain level was lower in the day and the third day than in the control group,the difference was statistically significant(P<0.05). However, the incidence of postoperative complications was not statistically significant(P>0.05). Conclusion Peer education combined with accelerated rehabilitation surgery can better improve the knee function and daily living ability of patients with TKA, and help them return to their families and society with early barriers or fewer obstacles.