本文選題：全膝關(guān)節(jié)置換術(shù) + 術(shù)后主動(dòng)屈膝時(shí)間��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:將兩種主動(dòng)屈膝時(shí)間應(yīng)用于全膝關(guān)節(jié)置換術(shù)后患者,探尋一種有利于患者膝關(guān)節(jié)功能恢復(fù)的最佳干預(yù)時(shí)間。方法:某三甲醫(yī)院骨科2015年10月-2016年07月收治的初次行全膝關(guān)節(jié)置換術(shù)患者,根據(jù)排除標(biāo)準(zhǔn)收集62例,采用隨機(jī)數(shù)字表分為兩組,根據(jù)剔除脫落標(biāo)準(zhǔn),最終納入病例60例。實(shí)驗(yàn)組(n=30)患者麻醉清醒后行患膝主動(dòng)屈膝練習(xí),根據(jù)Tens法則總共10次/組、3組/天,屈膝角度為患者最大承受范圍,鼓勵(lì)患者行踝泵運(yùn)動(dòng)及股四頭肌等長(zhǎng)收縮練習(xí),增加靜脈回流減輕患肢腫脹,功能鍛煉需患者疼痛可忍,循序漸進(jìn),術(shù)后2周屈膝度數(shù)≥90°;對(duì)照組(n=30)患者術(shù)后第3天開始進(jìn)行主動(dòng)屈膝練習(xí),屈膝之前進(jìn)行下肢肌力訓(xùn)練,其余功能鍛煉強(qiáng)度同實(shí)驗(yàn)組。兩組患者通過比較患膝VAS評(píng)分、腫脹度、關(guān)節(jié)活動(dòng)度、HSS評(píng)分來(lái)分析不同時(shí)間主動(dòng)屈膝鍛煉對(duì)全膝關(guān)節(jié)置換術(shù)后患者膝關(guān)節(jié)功能恢復(fù)的影響。將數(shù)據(jù)收集時(shí)間定為術(shù)前、術(shù)后第1天、第3天、第7天、第14天,采用醫(yī)學(xué)統(tǒng)計(jì)軟件SPSS19.0進(jìn)行結(jié)果統(tǒng)計(jì)分析,以此來(lái)對(duì)兩組患者膝關(guān)節(jié)功能進(jìn)行評(píng)價(jià)。結(jié)果:1.兩組患者術(shù)前年齡、性別差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.VAS評(píng)分:術(shù)前兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第1天、第3天、第7天兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組患者分值高于對(duì)照組;術(shù)后第14天差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.腫脹度:術(shù)前兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第1天患者術(shù)區(qū)棉墊包裹,影響測(cè)量結(jié)果準(zhǔn)確性,未給予測(cè)量;術(shù)后第3天、第7天兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組患者患肢腫脹度大于對(duì)照組;術(shù)后第14天兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.關(guān)節(jié)活動(dòng)度:術(shù)前兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組術(shù)后第1天未主動(dòng)屈膝,未測(cè)量膝關(guān)節(jié)活動(dòng)度;術(shù)后第3天、第7天、第14天兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05),總體實(shí)驗(yàn)組優(yōu)于對(duì)照組。5.HSS評(píng)分:術(shù)前兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第1天、第3天患者未下床行走,無(wú)法運(yùn)用HSS進(jìn)行膝關(guān)節(jié)評(píng)分;術(shù)后第7天、第14天兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組優(yōu)于對(duì)照組。結(jié)論:1.本研究表明:術(shù)后當(dāng)天進(jìn)行主動(dòng)屈膝能夠改善膝關(guān)節(jié)活動(dòng)度,縮短膝關(guān)節(jié)屈曲達(dá)到90°的時(shí)間,但加重了患肢腫脹、疼痛;2.本研究表明:術(shù)后當(dāng)天進(jìn)行主動(dòng)屈膝能夠能夠促進(jìn)患者膝關(guān)節(jié)功能的恢復(fù)。但由于研究時(shí)間較短,缺乏大樣本,長(zhǎng)期療效仍需進(jìn)一步觀察。
[Abstract]:Aim: to explore an optimal intervention time for the recovery of knee function in patients with total knee arthroplasty (TKA) by using two kinds of active flexion time. Methods: from October 2015 to July 2016, 62 patients with total knee arthroplasty were collected and divided into two groups by random digital table. According to the criterion of elimination and shedding, 60 cases of total knee arthroplasty were included. Patients in the experimental group were given active knee flexion exercises after anaesthesia. According to Tens's rule, 10 times a day, flexion angle was the maximum tolerance range of patients, and patients were encouraged to exercise ankle pump and quadriceps femoris equal-length contraction. Increase venous reflux to alleviate the swelling of the affected limb, functional exercise needs patient pain can be tolerated, gradual, 2 weeks after the knee flexion degree 鈮，

本文編號(hào)：1944555