整体护理干预在人工膝关节置换术中的应用

目的探讨整体护理干预对人工膝关节置换术患者康复的影响。方法选取杭州市桐庐县中医院2012年10月～2013年10月行人工膝关节置换术的患者共计60例，将患者随机分为观察组（30例）和对照组（30例）。观察组患者给予围术期整体化护理干预措施，对照组患者给予围术期常规护理措施。观察并比较两组患者术后不同时间视觉模拟疼痛评分（VAS）；比较两组患者术后首次下床时间、睡眠时间、住院时间等生理指标情况；比较两组膝关节HSS评分情况；比较两组患者术后12个月的生活质量评分。结果①两组患者术后即刻疼痛VAS评分差异无统计学意义（P〉0．05），而观察组患者术后24、48、72h的VAS评分显著低于对照组，差异有统计学意义（P〈0．05）。②观察组患者术后首次下床时间及住院时间与对照组比较，均明显缩短，术后24、48、72h睡眠时间明显较长，差异均有统计学意义（P〈0．05）。③观察组患者术后12个月生活质量评分项目饮食、睡眠、精神、对疾病的认知、配合治疗、日常生活、家庭支持等与对照组比较，均明显较高，差异均有统计学意义（P〈0．05）。④两组患者HSS评分各级别所占比例比较，差异有统计学意义（P〈0．05），观察组功能恢复明显好于对照组。结论整体护理干预模式可提高患者康复效果，改善患者术后生活质量，从而提高人工膝关节置换术的治疗效果。

Application of overall nursing intervention in patients with knee arthro- plasty

Objective To discuss the effects of overall nursing intervention on rehabilitation of patients with knee arthroplasty. Methods 60 patients with knee arthroplasty in Hospital of Traditional Chinese Medicine of Tonglu County in Hangzhou City from October 2012 to October 2013 were selected and divided into observation group and control group, with 30 cases in each group. The observation group was treated with perioperative overall nursing intervention measures, the control group was treated with perioperative conventional nursing measures. The VAS scores of different time between the two groups were observed and compared; the bed time, sleep time, the hospital stays between the two groups were observed; the HSS scores between the two groups were observed; life quality scores of 12 months after the operation between the two groups were observed. Results ①The difference of VAS scores after the operation between the two groups was not statistically significant （P 〉 0.05）; VAS scores at 24, 48, 72 hours after operation in observation group were lower than those in control group, the differences were statistically significant （P 〈 0.05）. ②The bed time, hospital stays in observation group were shorter, while sleep time at 24, 48, 72 hours after operation was longer than that in control group, the differences were statistically significant （P 〈 0.05）. ③The life quality scores of diet, sleep, spirit, disease cognition, treatment coordination, daily life, family support in observation group were all higher than those in control group, the differences were statistically significant （P 〈 0.05）. ④The difference of the proportion of HSS scores at all levels between the two groups was statistically significant （P 〈 0.05）, the functional recovery in obser- vation group was obviously better than the control group. Conclusion The overall nursing intervention mode can im- prove the effect of rehabilitation, improve patients quality of life and the therapeutic effect of artificial knee joint re- placement.