發(fā)布時間：2018-07-07 22:29

  本文選題：全膝關(guān)節(jié)置換術(shù) + 桃紅四物湯��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討全膝關(guān)節(jié)置換術(shù)后的患者應(yīng)用桃紅四物湯內(nèi)服對康復(fù)過程的影響,以為置換術(shù)后膝關(guān)節(jié)的康復(fù)提供治療思路。方法:選取2015年6月到2016年6月在我科接受治療并診斷為膝骨關(guān)節(jié)炎的患者,選取患者均接受單側(cè)全膝關(guān)節(jié)置換術(shù),并嚴(yán)格參照診斷標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)、脫落標(biāo)準(zhǔn),最終所得的研究對象共60例。采用隨機數(shù)余數(shù)分組方法進行分組,由一名非試驗參與者首先根據(jù)預(yù)計納入的樣本量按照隨機數(shù)字表獲得隨機數(shù)字,制定出隨機分組表格。將所得隨機數(shù)字放入按順序、不透光的密封信封中,然后由研究人員所確定的納入研究患者按照就診順序獲得密封信封中的隨機數(shù)字,根據(jù)隨機分組表格來確定該患者所進入的分組。最終獲得觀察組和對照組各30例患者。所有患者均接受由同一主任醫(yī)師、同一組醫(yī)師完成的全膝關(guān)節(jié)置換術(shù),并在術(shù)后接受相同的術(shù)后處理,而對照組在術(shù)后康復(fù)方面僅接受常規(guī)的康復(fù)訓(xùn)練,觀察組除接受常規(guī)康復(fù)訓(xùn)練外,還接受桃紅四物湯口服28天,并觀察兩組患者的VAS評分、膝關(guān)節(jié)活動度、膝關(guān)節(jié)腫脹程度、HSS評分這些指標(biāo)在術(shù)后不同時間點的變化情況,使用統(tǒng)計學(xué)軟件對這些數(shù)據(jù)進行處理分析。結(jié)果:(1)術(shù)后第1天,觀察組和對照組的VAS評分沒有顯著差異(P0.05);在術(shù)后第3天、第7天、第14天、第28天,比較兩組患者同時間點的VAS評分,觀察組均明顯小于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。(2)術(shù)后第3天,觀察組和對照組的ROM沒有顯著差異(P0.05);在術(shù)后第7天、第14天、第28天的ROM,比較兩組患者同時間點的ROM,觀察組均明顯大于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。(3)術(shù)后第1天,觀察組和對照組的膝周徑?jīng)]有顯著差異(P0.05);在術(shù)后第3天、第7天、第14天,比較兩組患者同時點的膝周徑,觀察組均明顯小于對照組,差異有統(tǒng)計學(xué)意義(P0.05);而在術(shù)后第28天,觀察組和對照組的膝周徑?jīng)]有顯著差異(P0.05)。(4)術(shù)后第3天,觀察組和對照組的HSS評分沒有顯著差異(P0.05);在術(shù)后第7天、第14天、第28天,比較兩組患者同時間點的HSS評分,觀察組均明顯大于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:兩組患者在術(shù)后28天時腫脹均已趨于正常;對全膝關(guān)節(jié)置換術(shù)后的患者在常規(guī)康復(fù)訓(xùn)練基礎(chǔ)上再使用桃紅四物湯內(nèi)服,能夠明顯緩解早期術(shù)后疼痛、腫脹,提高關(guān)節(jié)活動度和功能,能快速促進術(shù)后早期康復(fù)。
[Abstract]:Objective: to explore the effect of Taohong Siwu decoction on rehabilitation of patients after total knee arthroplasty. Methods: the patients who were treated in our department from June 2015 to June 2016 and diagnosed as knee osteoarthritis were all treated with unilateral total knee arthroplasty. A total of 60 cases were studied. By using the method of grouping random number remainder, a non-experimental participant first obtains random number according to the sample size expected to be included, and establishes a random grouping table. The random numbers were placed in sealed envelopes that were sequenced and impermeable, and then, as determined by the researchers, the random numbers in the sealed envelopes were obtained by the study patients in the order in which they were treated. A randomized grouping table was used to determine the group into which the patient entered. Finally, 30 patients in the observation group and 30 patients in the control group were obtained. All patients received total knee arthroplasty performed by the same chief physician and the same group of physicians, and received the same postoperative treatment after operation, while the control group received only routine rehabilitation training in postoperative rehabilitation. In addition to routine rehabilitation training, the observation group also received Taohong Siwu decoction orally for 28 days. The VAS score, knee motion degree, knee swelling degree and HSS score of the two groups were observed at different time points after operation. Use statistical software to process and analyze these data. Results: (1) on the first day after operation, there was no significant difference in VAS score between the observation group and the control group (P0.05), and on the 3rd, 7th, 14th, 28th day after operation, the VAS scores of the two groups were significantly lower than those of the control group. The difference was statistically significant (P0.05). (2) on the 3rd day after operation, there was no significant difference between the observation group and the control group (P0.05); on the 7th day, 14th day, 28th day after the operation, the rom of the two groups were significantly larger than that of the control group. The difference was statistically significant (P0.05). (3) on the 1st day after operation, there was no significant difference between the observation group and the control group (P0.05); on the 3rd, 7th, 14th day after operation, the observation group was significantly smaller than the control group. The difference was statistically significant (P0.05), but on the 28th day after operation, there was no significant difference in the knee circumference between the observation group and the control group (P0.05). There was no significant difference between the observation group and the control group on the third day after operation (P0.05); on the 7th day, 14th day, 28th day after operation, there was no significant difference between the observation group and the control group (P0.05). Compared the two groups of patients at the same time point of HSS scores, the observation group was significantly larger than the control group, the difference was statistically significant (P0.05). Conclusion: the swelling of the patients in the two groups has become normal at 28 days after operation, and the patients after total knee arthroplasty can be treated with Taohong Siwu decoction on the basis of routine rehabilitation training, which can obviously relieve the pain and swelling in the early postoperative period. Improving the range of motion and function of the joint can promote early postoperative rehabilitation.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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