老年患者膝关节置换术后微信随访延续康复的效果评价

目的通过微信随访模式对出院的骨科老年膝关节置换术后患者进行干预,评价骨科老年患者术后连续康复效果。方法选择蚌埠医学院第一附属医院2016年6月—2017年11月收治的70例在蚌埠医学院第一附属医院骨科行全膝关节置换术的患者进行了研究。根据随机数字表法,将其分为研究组和对照组各35例。出院前对患者基本信息登记,研究组患者出院时给予常规教育及离院后的微信随访;对照组在出院时给予常规教育。采用美国特种外科医院(the hospital for special surgery,HSS)的HSS膝关节评分系统对全膝关节置换术患者的术后2周、4周、3个月时的康复情况进行测评,评价患膝关节功能恢复情况、康复训练知识及技能、生活自理能力、心理因素,对研究组患者进行微信随访后续康复指导并予以相应干预,统计随访情况。结果 2组患者术前HSS评分差异无统计学意义(P>0.05)。术后2周、4周和3个月,研究组患者的HSS评分高于对照组(均P<0.05),差异有统计学意义。干预后不同时间段对照,患者的膝关节功能、康复知识及技能掌握、生活自理能力提高较明显、心理问题明显得到解决。结论微信随访延续干预有效消除患者不良心理,提高康复训练知识及技能,促进膝关节功能恢复,提高患者生活自理能力,改善生活质量,提高了患者随访依从性。

Efficacy of rehabilitation intervention by WeChat follow-up in elderly patients after knee replacement surgery

Objective To performed WeChat follow-up among the elderly patients in the postoperative rehabilitation after knee replacement surgery and assess evaluate the efficacy of the continuation of rehabilitation program. Methods Seventy patients undergoing total knee arthroplasty in our hospital between June 2016 and November 2017 were enrolled and divided into study group and control group by using the random number table method, with 35 cases in each group. The basic information of all patients was registered before discharge. The patients of study group received the general discharge instructions and follow-up by WeChat after discharge, the suitable rehabilitation intervention was carried out according to the conditions; while the control was given the general discharge instructions. Hospital for Special Surgery (HSS) knee score system (KSS) was used to assess the postoperative rehabilitation of patients 2 weeks, 4 weeks and 3 months after the surgery, including the degree of knee flexion and extension, knowledge and skills for rehabilitation training, self-care ability and psychological health. The result was statistically analyzed. Results There was no significant difference in HSS knee score before the surgery between the two groups (P>0.05). At 2 weeks, 4 weeks and 3 months after the surgery, the knee score of the study group was higher than that of the control group, and the difference was statistically significant (all P<0.05). After the intervention through WeChat follow-up, the knee flexion and extension, knowledge and skills for rehabilitation, self-care ability and psychological health of the patients were significantly improved. Conclusion The rehabilitation intervention by WeChat follow-up can effectively relieve the unhealthy psychological factors of patients, improve the patients' knowledge and skills for rehabilitation, knee function, self-care ability and quality of life, and the follow-up compliance.