膝關(guān)節(jié)置換術(shù)后壓迫患膝伸直的護理作用分析及新型氣囊壓迫裝置的研制
發(fā)布時間：2018-09-18 07:30
【摘要】：目的:明確膝關(guān)節(jié)置換術(shù)后壓迫患膝伸直的護理措施對促進患者功能恢復的積極影響;研制一種防治人工全膝關(guān)節(jié)置換術(shù)后患膝發(fā)生伸直障礙的新型氣囊壓迫裝置,以期為患者康復及臨床護理工作提供良好而有效的工具。方法:第一部分:病例的回顧性分析選取某三甲醫(yī)院自2011至2015年間骨科關(guān)節(jié)組行全膝關(guān)節(jié)置換術(shù)的159例患者病歷資料進行回顧性分析,探討重物壓迫的護理方式對防治全膝關(guān)節(jié)置換術(shù)后患膝發(fā)生伸直障礙的影響,同時客觀評價現(xiàn)有護理器具的不足之處,作為支持本研究的基礎(chǔ)。第二部分:國人膝關(guān)節(jié)幾何參數(shù)的測量選取2016年5至7月該院住院患者中骨骼發(fā)育成熟且正常的成年人200例,其中男、女各100例。每位受測對象分別測量左、右兩側(cè)膝關(guān)節(jié)的外部形態(tài)并記錄幾何參數(shù),從而為新型氣囊壓迫裝置的設計提供數(shù)據(jù)基礎(chǔ)。第三部分:新型氣囊壓迫裝置的設計在膝關(guān)節(jié)幾何參數(shù)測量的基礎(chǔ)之上,借鑒以往防治關(guān)節(jié)攣縮的理論原理,設計新型氣囊壓迫裝置,并分析其性能,檢測臨床實用性。本研究所收集的數(shù)據(jù)均采用SPSS17.0進行分析,定量資料采用`X±S表示,定性資料采用率和構(gòu)成比;計數(shù)資料采用c2或Fisher確切概率法,非參數(shù)秩和檢驗;計量資料采用t檢驗,以P0.05認為差異有統(tǒng)計學意義。結(jié)果:1.病例的回顧性分析顯示:全膝關(guān)節(jié)置換術(shù)后膝關(guān)節(jié)上方是否行重物壓迫對防治患膝伸直障礙的發(fā)生比較差異有統(tǒng)計學意義,術(shù)后關(guān)節(jié)上方行重物壓迫可減少患膝伸直障礙的發(fā)生。2.國人膝關(guān)節(jié)幾何參數(shù)的測量結(jié)果顯示:同一性別左右膝關(guān)節(jié)幾何參數(shù)比較無差異,不同性別間膝關(guān)節(jié)幾何參數(shù)比較差異有統(tǒng)計學意義,故在裝置設計中應區(qū)分性別差異。3.依據(jù)國人膝關(guān)節(jié)幾何參數(shù)測量結(jié)果及靜態(tài)進展性伸展原理,從全新的角度設計了一種新型裝置“氣囊壓迫裝置”,并成功申請下國家專利。該裝置采用氣囊對患膝進行壓迫,保證關(guān)節(jié)與氣囊接觸面上受力均勻;與氣囊連通的壓力表,可實時顯示氣囊對患膝作用力的大小;使用中依據(jù)患者個人疼痛耐受情況,逐次、逐日循序漸進地增加壓力值,最終達到患膝完全伸直的目的。結(jié)論:重物壓迫的護理方式對防治全膝關(guān)節(jié)置換術(shù)后患膝發(fā)生伸直障礙的作用有效,故術(shù)后護理措施對促進患者功能恢復有積極影響;基于國人膝關(guān)節(jié)幾何參數(shù)的測量結(jié)果,研制的新型氣囊壓迫裝置壓力可控,方便監(jiān)督,舒適度高,臨床初步檢測該裝置使用中可減輕患者康復期的疼痛程度,增加關(guān)節(jié)活動度,最終達到壓迫關(guān)節(jié)伸直的效果。
[Abstract]:Objective: to determine the positive effect of nursing measures on the functional recovery of patients with knee extension after knee arthroplasty, and to develop a new type of balloon compression device for preventing and treating knee extension disorders after total knee arthroplasty. In order to provide good and effective tools for patient rehabilitation and clinical nursing work. Methods: the first part: the medical records of 159 patients who underwent total knee arthroplasty in orthopaedic joint group from 2011 to 2015 in a third Class A Hospital were retrospectively analyzed. To explore the effect of heavy body compression on the prevention and treatment of knee extension disorder after total knee arthroplasty, and to evaluate objectively the deficiencies of existing nursing instruments as the basis of this study. The second part: from May to July 2016, 200 adult adults with mature and normal bones were selected, including 100 males and 100 females, for the measurement of knee joint geometric parameters. The external shapes of the left and right knee joints were measured and the geometric parameters were recorded to provide a data basis for the design of a new type of air bag compression device. The third part: based on the measurement of the geometric parameters of the knee joint, a new type of air bag compression device is designed based on the previous theory of preventing and treating joint contracture, and its performance is analyzed, and the clinical practicability is tested. The data collected in this study are analyzed by SPSS17.0, the quantitative data are expressed as'X 鹵S', the qualitative data are expressed by the rate and composition ratio, the counting data are calculated by using the exact probability method of c 2 or Fisher, the non-parametric rank sum test is used, the measurement data is expressed by t test. P0.05 thought the difference was statistically significant. The result is 1: 1. The retrospective analysis showed that there were significant differences in the prevention and treatment of knee extension disorders after total knee arthroplasty. After operation, the incidence of knee extension dysfunction was reduced by weight compression on the upper part of the joint. The measurement results of Chinese knee joint geometric parameters show that there is no difference between the right and left knee joint geometric parameters in the same sex, and there is statistical significance in the comparison of the knee joint geometric parameters between the different sexes. Therefore, in the design of the device, the gender difference should be distinguished. According to the measurement results of Chinese knee joint geometric parameters and the principle of static progressive extension, a new type of device called air bag compression device was designed from a new angle, and successfully applied for a national patent. The device uses air bags to compress the affected knee to ensure that the joint is evenly loaded on the contact surface of the air bag; the pressure gauge connected with the air bag can display the force of the air bag on the affected knee in real time; and in use, according to the patient's personal pain tolerance, the pressure gauge can be used one by one according to the patient's individual pain tolerance. Step by day step by step increase the pressure value, and finally reach the goal of complete knee straightening. Conclusion: the nursing mode of heavy body compression is effective in preventing and treating knee extension disorder after total knee arthroplasty, so postoperative nursing measures have a positive effect on promoting the recovery of patients' function, based on the measurement results of Chinese knee joint geometric parameters. The pressure of the new kind of air bag compression device is controllable, easy to supervise, and its comfort is high. The clinical preliminary examination can reduce the pain degree of the patient during the recovery period, increase the motion of the joint, and finally achieve the effect of pressing the joint to straighten out.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.6
本文編號：2247219
[Abstract]:Objective: to determine the positive effect of nursing measures on the functional recovery of patients with knee extension after knee arthroplasty, and to develop a new type of balloon compression device for preventing and treating knee extension disorders after total knee arthroplasty. In order to provide good and effective tools for patient rehabilitation and clinical nursing work. Methods: the first part: the medical records of 159 patients who underwent total knee arthroplasty in orthopaedic joint group from 2011 to 2015 in a third Class A Hospital were retrospectively analyzed. To explore the effect of heavy body compression on the prevention and treatment of knee extension disorder after total knee arthroplasty, and to evaluate objectively the deficiencies of existing nursing instruments as the basis of this study. The second part: from May to July 2016, 200 adult adults with mature and normal bones were selected, including 100 males and 100 females, for the measurement of knee joint geometric parameters. The external shapes of the left and right knee joints were measured and the geometric parameters were recorded to provide a data basis for the design of a new type of air bag compression device. The third part: based on the measurement of the geometric parameters of the knee joint, a new type of air bag compression device is designed based on the previous theory of preventing and treating joint contracture, and its performance is analyzed, and the clinical practicability is tested. The data collected in this study are analyzed by SPSS17.0, the quantitative data are expressed as'X 鹵S', the qualitative data are expressed by the rate and composition ratio, the counting data are calculated by using the exact probability method of c 2 or Fisher, the non-parametric rank sum test is used, the measurement data is expressed by t test. P0.05 thought the difference was statistically significant. The result is 1: 1. The retrospective analysis showed that there were significant differences in the prevention and treatment of knee extension disorders after total knee arthroplasty. After operation, the incidence of knee extension dysfunction was reduced by weight compression on the upper part of the joint. The measurement results of Chinese knee joint geometric parameters show that there is no difference between the right and left knee joint geometric parameters in the same sex, and there is statistical significance in the comparison of the knee joint geometric parameters between the different sexes. Therefore, in the design of the device, the gender difference should be distinguished. According to the measurement results of Chinese knee joint geometric parameters and the principle of static progressive extension, a new type of device called air bag compression device was designed from a new angle, and successfully applied for a national patent. The device uses air bags to compress the affected knee to ensure that the joint is evenly loaded on the contact surface of the air bag; the pressure gauge connected with the air bag can display the force of the air bag on the affected knee in real time; and in use, according to the patient's personal pain tolerance, the pressure gauge can be used one by one according to the patient's individual pain tolerance. Step by day step by step increase the pressure value, and finally reach the goal of complete knee straightening. Conclusion: the nursing mode of heavy body compression is effective in preventing and treating knee extension disorder after total knee arthroplasty, so postoperative nursing measures have a positive effect on promoting the recovery of patients' function, based on the measurement results of Chinese knee joint geometric parameters. The pressure of the new kind of air bag compression device is controllable, easy to supervise, and its comfort is high. The clinical preliminary examination can reduce the pain degree of the patient during the recovery period, increase the motion of the joint, and finally achieve the effect of pressing the joint to straighten out.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.6
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