术后早期功能锻炼对老年全膝关节置换术后伴恐动心理患者的影响

目的 分析老年全膝关节置换术伴恐动心理患者术后早期行功能康复锻炼的体验及效果。方法 将铜陵市立医院骨科收治并行全膝关节置换，术后有恐动症的90例老年患者分为观察组及对照组，每组45例。对照组应用一般护理措施，观察组在恐动心理调查的基础上实施早期功能锻炼指导，比较两组患者恐动改善情况、生活质量变化、膝关节功能恢复情况，并对患者进行术后恐动原因调查，分析其对早期功能锻炼的体验和感受。结果 出院时及出院1、3、6个月，观察组的恐动程度比对照组轻（P?0.05）；术后6个月观察组患者的SF-36评分高于对照组（P?0.05），膝关节功能相比于对照组明显改善（P?0.05）；术后恐动体验调查显示，疼痛恐惧、对早期锻炼不确定感、压力大及支持系统薄弱是影响功能锻炼依从性的主要原因。结论 全膝关节置换术后患者容易出现恐动症，临床上需在有效恐动评估的基础上给予早期功能锻炼指导，促进术后膝关节功能康复；医护人员及家庭的支持对减轻患者疼痛的恐惧感及提高康复锻炼依从性有益。

Effect of early rehabilitation exercises promotes the recovery of elderly patients with kinesiophobia after total knee arthroplasty

Objective To investigate the effect of early functional rehabilitation exercises in elderly patients with kinesiophobia after total knee arthroplasty. Methodsarthroplasty. Methods Ninety elderly patients who received total knee replacement in Orthopedics Department of Tongling Municipal Hospital were divided into observation group and control group, with 45 cases in each group. The patients in control group were treated with general nursing. And the early functional exercises designed according to the results of psychological investigation were performed in observation group. The improvement of psychological states, changes in quality of life and the recovery of knee joint function were compared between the two groups of patients. The causes of psychomotor psychosis were analyzed. Results The degree of kinesiophobia in the observation group was less than that of the control group at discharge and 1, 3, and 6 months after discharge (P?0.05). The SF-36 score of the observation group was higher than that of the control group at 6 months after operation (P?0.05) . The knee joint function was significantly improved in the patients of control group (P?0.05). The fear of pain, uncertainty about early exercise, high pressure and weak support system were the main causes affecting the compliance of functional exercises. Conclusion Patients receiving total knee arthroplasty are prone to kinesiophobia. Clinically, it is necessary to provide early functional exercise guidance on the basis of effective panic assessment to promote postoperative knee function recovery. The supports from medical staff and families to relieve the fear of pain in patients are beneficial to improve the compliance of rehabilitation exercise.