本文選題：加速康復(fù)外科 + 全膝關(guān)節(jié)置換��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的在加速康復(fù)外科護(hù)理基礎(chǔ)上綜合舒適護(hù)理措施,探討加速康復(fù)外科舒適護(hù)理對(duì)人工全膝關(guān)節(jié)置換術(shù)患者圍術(shù)期疼痛改善狀況、膝關(guān)節(jié)功能恢復(fù)程度、舒適感及住院滿意度的影響;為促進(jìn)加速康復(fù)外科舒適護(hù)理在關(guān)節(jié)外科的應(yīng)用提供臨床實(shí)踐經(jīng)驗(yàn)。方法通過(guò)文獻(xiàn)回顧、加速康復(fù)外科舒適護(hù)理小組討論、預(yù)試驗(yàn)等方法確定加速康復(fù)外科舒適護(hù)理措施。采用目的抽樣的方法,選擇山東省青島市某三級(jí)甲等醫(yī)院2015.9~2016.4收治的行單側(cè)人工全膝關(guān)節(jié)置換術(shù)的82例老年患者,使用一般資料調(diào)查表收集資料,收集患者術(shù)前一般資料、關(guān)節(jié)功能和疼痛評(píng)分等。將82例基線評(píng)估合格的患者納入研究,其中2015.9.8~12.8符合納入標(biāo)準(zhǔn)的41例患者為對(duì)照組,2015.12.10~2016.4.1符合納入標(biāo)準(zhǔn)的41例患者為觀察組。給與對(duì)照組患者研究所在醫(yī)院的常規(guī)護(hù)理措施,觀察組患者實(shí)施加速康復(fù)外科舒適護(hù)理措施。采集兩組在入院時(shí)及術(shù)后3d、出院1個(gè)月的膝關(guān)節(jié)功能評(píng)分、入院時(shí)疼痛災(zāi)難化評(píng)分、連續(xù)采集術(shù)后4天的關(guān)節(jié)活動(dòng)度及疼痛視覺(jué)模擬評(píng)分,記錄兩組患者術(shù)后勾腳開(kāi)始時(shí)間、術(shù)后首次下床時(shí)間、住院滿意度及平均術(shù)后住院天數(shù)及睡眠質(zhì)量。結(jié)果1.兩組患者在年齡、性別、體重指數(shù)、入院時(shí)膝關(guān)節(jié)評(píng)分、入院時(shí)疼痛災(zāi)難化評(píng)分及疼痛評(píng)分、入院時(shí)關(guān)節(jié)活動(dòng)度、術(shù)前血紅蛋白及白蛋白、手術(shù)時(shí)間等基本資料均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.觀察組術(shù)后勾腳開(kāi)始時(shí)間(h)(2.56±1.25)早于對(duì)照組(11.48±4.48)、術(shù)后平均首次下床時(shí)間(d)(2.06±3.31)早于對(duì)照組(2.66±0.47)、術(shù)后12h VAS評(píng)分(4.7±1.01)低于對(duì)照組(6.57±1.19),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.觀察組術(shù)后3d HSS評(píng)分(34.21±1.65)高于對(duì)照組(31.23±1.83),出院1個(gè)月HSS(83.23±3.81)高于對(duì)照組(78.69±5.06)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.重復(fù)測(cè)量方差分析結(jié)果顯示,兩組在關(guān)節(jié)活動(dòng)度及疼痛評(píng)分的組間效應(yīng)和時(shí)間效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),關(guān)節(jié)活動(dòng)度及疼痛評(píng)分與時(shí)間因素存在交互效應(yīng),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5.觀察組術(shù)后平均住院天數(shù)(4.48±0.87)短于對(duì)照組(6.81±1.53)、住院滿意度(97.71±2.78)高于對(duì)照組(94.16±6.81),觀察組睡眠質(zhì)量?jī)?yōu)良數(shù)(1.64±0.48)高于對(duì)照組(1.35±0.48),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1.將加速康復(fù)外科綜合舒適護(hù)理的護(hù)理措施應(yīng)用到全膝關(guān)節(jié)置換術(shù)患者圍術(shù)期護(hù)理中,可縮短術(shù)后首次下床時(shí)間,增加患者每日運(yùn)動(dòng)量。2.將加速康復(fù)外科綜合舒適護(hù)理的優(yōu)化護(hù)理措施應(yīng)用到全膝關(guān)節(jié)置換術(shù)患者圍術(shù)期護(hù)理中,可有效緩解患者疼痛程度,緩解患者心理壓力,提高患者生理舒適感和住院滿意度。3.將加速康復(fù)外科綜合舒適護(hù)理的優(yōu)化護(hù)理措施應(yīng)用到全膝關(guān)節(jié)置換術(shù)患者圍術(shù)期護(hù)理中,可加快患者術(shù)后早期關(guān)節(jié)功能恢復(fù),縮短術(shù)后住院時(shí)間,對(duì)全膝關(guān)節(jié)置換手術(shù)術(shù)后康復(fù)有明顯的積極作用。
[Abstract]:Objective to explore the improvement of perioperative pain and the degree of knee joint function recovery in patients undergoing total knee arthroplasty with accelerated rehabilitation surgery on the basis of comprehensive comfort nursing measures. The effect of comfort and hospital satisfaction, and provide clinical experience for promoting the application of accelerated rehabilitation surgery comfort nursing in joint surgery. Methods through literature review, the group discussion of accelerated rehabilitation surgery comfort nursing, pre-test and other methods to determine the accelerated rehabilitation surgery comfort care measures. Objective to select 82 elderly patients who underwent unilateral total knee arthroplasty in a Grade 3A hospital in Qingdao, Shandong Province. The data were collected by general information questionnaire and general data were collected before operation. Joint function and pain score. Eighty-two patients with qualified baseline assessment were included in the study, of which 41 patients who met the inclusion criteria were the control group. 41 patients who met the inclusion criteria were the observation group. The patients in the control group were given routine nursing measures in hospital, while the patients in the observation group were given the comfort nursing measures of accelerated rehabilitation surgery. The knee joint function score at admission and 3 days after discharge, the pain disaster score on admission, the joint motion and visual analogue score of pain on 4 days after operation were collected. The first time of getting out of bed after operation, hospital satisfaction, average postoperative hospitalization days and sleep quality. Result 1. Age, sex, body mass index, knee joint score at admission, pain disaster score and pain score at admission, joint motion at admission, preoperative hemoglobin and albumin, The operation time and other basic data were not statistically significant P 0.05. 2. The onset time of foot hook in the observation group was 2.56 鹵1.25) earlier than that in the control group (11.48 鹵4.48), and the average first time of getting out of bed was 2.06 鹵3.31) earlier than that in the control group (2.66 鹵0.47), and the VAS score at 12 hours after operation was lower than that in the control group (6.57 鹵1.19). The difference was statistically significant. The HSS score (34.21 鹵1.65) in the observation group was higher than that in the control group (31.23 鹵1.83), and the HSS(83.23 鹵3.81 at one month after discharge in the observation group was significantly higher than that in the control group (78.69 鹵5.06). The results of repeated measurement analysis of variance showed that there were significant differences in the effect and time effect between the two groups in the range of joint motion and pain score (P 0.05), and there was an interactive effect between joint motion and pain score and time factor, and the difference was statistically significant (P 0.05). The average postoperative hospitalization days in the observation group were less than that in the control group (6.81 鹵1.53), the hospital satisfaction was 97.71 鹵2.78) and the sleep quality in the observation group was higher than that in the control group (94.16 鹵6.81), and the number of good sleep quality in the observation group was 1.64 鹵0.48) higher than that in the control group (1.35 鹵0.48), the difference was statistically significant (P 0.05). Conclusion 1. Applying the comprehensive comfortable nursing measures of accelerated rehabilitation surgery to the perioperative nursing care of the patients undergoing total knee arthroplasty can shorten the first time of getting out of bed after operation and increase the daily exercise amount of the patients. Applying the optimized nursing measures of comprehensive comfort nursing in rehabilitation surgery to the perioperative nursing care of patients undergoing total knee arthroplasty can effectively relieve the pain degree of the patients, relieve the psychological pressure of the patients, and improve the physiological comfort of the patients and the satisfaction degree of the patients in hospital. Applying the optimized nursing measures of comprehensive and comfortable nursing of accelerated rehabilitation surgery to perioperative nursing care of patients undergoing total knee arthroplasty can accelerate the recovery of early postoperative joint function and shorten the postoperative hospitalization time. It has a positive effect on postoperative rehabilitation of total knee arthroplasty.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 許順恩;劉日光;莊勇;汪健;;髕骨周?chē)ド窠?jīng)化對(duì)保留髕骨的全膝關(guān)節(jié)置換術(shù)術(shù)后影響的Meta分析[J];中華臨床醫(yī)師雜志(電子版);2016年17期

2 袁普衛(wèi);康武林;李小群;董博;劉德玉;王偉卓;;骨性關(guān)節(jié)炎發(fā)病機(jī)制及相關(guān)細(xì)胞因子的研究進(jìn)展[J];中國(guó)矯形外科雜志;2016年11期

3 魏星;;健康教育及心理護(hù)理干預(yù)在風(fēng)濕性關(guān)節(jié)炎患者護(hù)理中的應(yīng)用效果評(píng)價(jià)[J];當(dāng)代護(hù)士(上旬刊);2016年05期

4 沙勇;;人口老齡化趨勢(shì)下的基本公共服務(wù)供給探究——以江蘇省為例[J];江蘇社會(huì)科學(xué);2016年02期

5 鐘秋苑;;快速康復(fù)外科理念聯(lián)合舒適護(hù)理在直腸癌手術(shù)病人中的應(yīng)用[J];全科護(hù)理;2016年09期

6 曲音音;徐懋;;快速康復(fù)外科理念下全膝關(guān)節(jié)置換術(shù)圍術(shù)期鎮(zhèn)痛進(jìn)展[J];中國(guó)微創(chuàng)外科雜志;2016年02期

7 周宗科;翁習(xí)生;曲鐵兵;張先龍;嚴(yán)世貴;曹力;朱振安;廖威明;錢(qián)齊榮;楊柳;朱慶生;吳海山;史占軍;黃偉;趙建寧;錢(qián)文偉;廖刃;劉斌;孫學(xué)禮;王坤正;邱貴興;裴福興;;中國(guó)髖、膝關(guān)節(jié)置換術(shù)加速康復(fù)——圍術(shù)期管理策略專(zhuān)家共識(shí)[J];中華骨與關(guān)節(jié)外科雜志;2016年01期

8 吳素琴;張細(xì)順;陳燕芹;;延續(xù)性護(hù)理對(duì)全膝關(guān)節(jié)置換術(shù)病人功能恢復(fù)及生活質(zhì)量的影響[J];全科護(hù)理;2015年34期

9 馬洪升;蔣麗莎;劉洋;李志超;;快速康復(fù)外科理念在日間手術(shù)中的實(shí)踐[J];中國(guó)普外基礎(chǔ)與臨床雜志;2015年11期

10 王曉青;岳冰;;圍術(shù)期綜合護(hù)理干預(yù)對(duì)全膝置換術(shù)患者術(shù)后疼痛的影響[J];西部醫(yī)學(xué);2015年08期

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