【摘要】：目的:明確膝關(guān)節(jié)置換術(shù)后壓迫患膝伸直的護(hù)理措施對(duì)促進(jìn)患者功能恢復(fù)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(fù)及臨床護(hù)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(jìn)行回顧性分析,探討重物壓迫的護(hù)理方式對(duì)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(shí)客觀評(píng)價(jià)現(xiàn)有護(hù)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(cè)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(cè)對(duì)象分別測(cè)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(shè)計(jì)提供數(shù)據(jù)基礎(chǔ)。第三部分:新型氣囊壓迫裝置的設(shè)計(jì)在膝關(guān)節(jié)幾何參數(shù)測(cè)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(shè)計(jì)新型氣囊壓迫裝置,并分析其性能,檢測(cè)臨床實(shí)用性。本研究所收集的數(shù)據(jù)均采用SPSS17.0進(jìn)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(jì)數(shù)資料采用c2或Fisher確切概率法,非參數(shù)秩和檢驗(yàn);計(jì)量資料采用t檢驗(yàn),以P0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)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(duì)防治患膝伸直障礙的發(fā)生比較差異有統(tǒng)計(jì)學(xué)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(cè)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(jì)學(xué)意義,故在裝置設(shè)計(jì)中應(yīng)區(qū)分性別差異。3.依據(jù)國人膝關(guān)節(jié)幾何參數(shù)測(cè)量結(jié)果及靜態(tài)進(jìn)展性伸展原理,從全新的角度設(shè)計(jì)了一種新型裝置“氣囊壓迫裝置”,并成功申請(qǐng)下國家專利。該裝置采用氣囊對(duì)患膝進(jìn)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(shí)時(shí)顯示氣囊對(duì)患膝作用力的大小;使用中依據(jù)患者個(gè)人疼痛耐受情況,逐次、逐日循序漸進(jìn)地增加壓力值,最終達(dá)到患膝完全伸直的目的。結(jié)論:重物壓迫的護(hù)理方式對(duì)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(hù)理措施對(duì)促進(jìn)患者功能恢復(fù)有積極影響;基于國人膝關(guān)節(jié)幾何參數(shù)的測(cè)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(cè)該裝置使用中可減輕患者康復(fù)期的疼痛程度,增加關(guān)節(jié)活動(dòng)度,最終達(dá)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(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張景祥;李金松;;人工全膝關(guān)節(jié)置換術(shù)治療膝骨關(guān)節(jié)屈曲內(nèi)翻畸形320例[J];實(shí)用中醫(yī)藥雜志;2015年09期

2 楊莉;高麗;劉琦;路茜;張麗;岳穎;;半導(dǎo)體激光治療儀在全膝關(guān)節(jié)置換術(shù)后病人中的應(yīng)用[J];護(hù)理研究;2015年15期

3 張?jiān)品f;張燕;;全膝關(guān)節(jié)置換術(shù)后懸吊抬高屈曲位對(duì)患肢腫脹的影響[J];護(hù)理研究;2015年03期

4 計(jì)忠偉;包倪榮;趙建寧;;人工全膝關(guān)節(jié)置換術(shù)后疼痛原因分析[J];中國骨傷;2014年11期

5 王嬌;張玉梅;;冰敷壓迫法對(duì)全膝關(guān)節(jié)置換術(shù)后早期康復(fù)的影響[J];護(hù)士進(jìn)修雜志;2014年22期

6 劉紅麗;孫凱;班月敏;金社輝;;人工膝關(guān)節(jié)置換術(shù)后的康復(fù)護(hù)理體會(huì)[J];臨床合理用藥雜志;2014年31期

7 何翠環(huán);;壓腿練習(xí)對(duì)人工膝關(guān)節(jié)伸直功能的作用分析[J];當(dāng)代護(hù)士(中旬刊);2014年09期

8 王鍇;彭丹丹;林劍浩;;實(shí)施臨床路徑對(duì)人工膝關(guān)節(jié)置換術(shù)住院費(fèi)用的影響分析[J];中國衛(wèi)生經(jīng)濟(jì);2013年11期

9 卿忠;姚建鋒;張育民;許鵬;朱養(yǎng)均;彭侃;;屈曲攣縮畸形全膝關(guān)節(jié)置換的軟組織平衡[J];中國骨與關(guān)節(jié)損傷雜志;2013年10期

10 李軍;畢勝;;靜態(tài)進(jìn)展型支具在關(guān)節(jié)攣縮中的應(yīng)用進(jìn)展[J];中國康復(fù)醫(yī)學(xué)雜志;2013年08期

相關(guān)博士學(xué)位論文 前1條

1 李紅衛(wèi);“智能可調(diào)式下肢抬高系統(tǒng)”的研制及在關(guān)節(jié)置換術(shù)后康復(fù)的應(yīng)用研究[D];南京中醫(yī)藥大學(xué);2015年

相關(guān)碩士學(xué)位論文 前2條

1 孫英;功能鍛煉記錄表在全膝關(guān)節(jié)置換術(shù)后患者中的應(yīng)用[D];青島大學(xué);2015年

2 李梁;國人股骨遠(yuǎn)端形態(tài)的測(cè)量及其在全膝關(guān)節(jié)置換與假體設(shè)計(jì)中的意義[D];第二軍醫(yī)大學(xué);2012年

，

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