全膝关节置换术后关节挛缩患者的护理及康复疗效探讨

目的：该研究旨在通过对比全膝关节置换（TKA）术后关节挛缩患者住院康复和门诊康复的疗效，探讨护理对TKA术后关节挛缩患者的康复疗效的影响。方法2010—2013年间该院收治TKA术后关节挛缩患者44例，随机分为住院组20例和门诊组24例，分别行团队康复和单纯功能康复治疗。治疗前、后及6个月随访时分别行满意度和西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC）评价。结果相比门诊组，住院组治疗后和6个月随访时的满意度更高（P〈0.05）；住院组的治疗后和6个月随访时的WOMAC评分更高（P〈0.05）；住院组并发症更少。结论对于TKA术后关节挛缩患者，以功能康复和医学护理为主的团队康复比单纯功能康复效果更好，患者满意度更高，医学护理可能有助于减少TKA术后关节挛缩患者的并发症。

The Effect of Nursing and Rehabilitation for Postoperative Joint Contracture of Patients with Total Knee Arthroplasty

Objective The purpose of this study is to investigate the effect of nursing on the rehabilitation of patients with joint contracture after total knee arthroplasty（TKA） by comparing the effect between inpatient rehabilitation and outpatient rehabilitation on the patients. Methods 44 patients with joint contracture after TKA admitted in our hospital from 2010 to 2013 were randomly divided into the inpatient group 20 cases and outpatient group 24 cases, and given the team rehabilitation and simple functional rehabilitation, respectively. Evaluation of the level of satisfaction and Western Ontario and McMaster Universities Osteoarthritis In-dex （WOMAC） was performed on admission, after treatment, and at 6-month follow-up. Results Compared with outpatient group, inpatient group had higher level of satisfaction after treatment and at 6-month follow-up （P〈0.05） and better WOMAC scale after treatment and at 6-month follow-up （P〈0.05）, and less complications. Conclusion For patients with joint contracture after TKA, team rehabilitation characterized by function rehabilitation and medical care has better effect and higher level of patient satisfaction than simple function rehabilitation; medical care may help to decrease the complications occurred in the patients with joint contracture after TKA.