膝关节置换者的自我管理模式

背景：自我管理模式是一种新型的疾病干预模式,可显著改善患者的健康行为及健康状况,同时减少住院天数和次数,降低医疗费用,已日渐成为人工膝关节置换后康复的研究热点,但其研究多集中在西方国家,国内报道较少。目的：探讨自我管理模式在膝关节置换患者康复中的应用价值。方法：选择膝关节置换住院患者84例,随机分为对照组和实验组,实验组采取自我管理模式,对照组采取常规教育模式,利用自我管理调查表、膝关节评分、住院时间和膝关节屈曲达90°所需时间来评价干预效果,比较两组干预前后相关参数的变化。结果与结论：两组患者自我管理得分和膝关节评分均有提高,实验组显著优于对照组（P〈0.05）;住院天数和膝关节屈曲90°所需时间均有缩短,实验组显著低于对照组（P〈0.05）。结果显示自我管理模式可有效提高膝关节置换患者自我管理能力,改善膝关节功能,提高生活质量。

Self-management approaches following total knee arthroplasty

BACKGROUND：Self-management is a new mode of disease intervention,and it can significantly improve the patient＇s health behavior and health status,while reducing the number of hospital days and lowering medical costs,which is becoming a focus for the rehabilitation after total knee arthroplasty.However,more studies are concentrated in the Western countries,and fewer reports in China.OBJECTIVE：To evaluate the application value of the self-management approaches during rehabilitation exercise for the first total knee arthroplasty.METHODS：Eighty-four patients with total knee arthroplasty were randomly divided into two groups：Experimental group received the intervention of self-management,and control group received routine care.RESULTS AND CONCLUSION：The intervention of self-management improved scores on patients ability of self-management（P 0.05） and HSS（P 0.05）,and decreased hospitalization days and days when the knee joints were flexed beyond 90（P 0.05）.The self-management approaches can improve the patients ability of self-management,and ameliorate the knee function and the quality of life.