本文選題：全膝關節(jié)置換　切入點：中醫(yī)特色療法　出處：《廣州中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:以全膝關節(jié)置換術后患者為研究對象,結(jié)合快速康復外科,應用中醫(yī)特色療法,觀察手術后患者膝關節(jié)功能評分、疼痛評分等專科情況以及排氣時間、下地時間、睡眠質(zhì)量等一般情況與對照組的差別,觀察中醫(yī)特色療法結(jié)合快速康復外科應用于全膝關節(jié)置換術后患者的有效性及安全性,從而促進全膝關節(jié)置換術后患者康復。方法:選取2016年2月起至2017年2月在廣州中醫(yī)藥大學第三附屬醫(yī)院關節(jié)科行人工全膝關節(jié)置換并符合納入標準的患者60人。隨機分配為治療組及對照組,兩組均實行快速康復外科模式,治療組再配合中醫(yī)特色療法(耳穴壓籽、穴位貼敷、吳茱萸熱包)。兩組病人均由同一組醫(yī)療團隊按照同一手術方式(膝前正中切口切開皮膚,經(jīng)髕骨內(nèi)側(cè)切口切開關節(jié)囊,后交叉韌帶替代型膝關節(jié)假體)行不置換髕骨的單側(cè)人工全膝關節(jié)置換術。對兩組患者一般資料進行對比及作統(tǒng)計學分析,確定一般資料無統(tǒng)計學差異,基線水平一致,具有可比性。記錄兩組患者術后膝關節(jié)功能評分、疼痛評分等�？魄闆r以及排氣時間、下地時間、睡眠質(zhì)量等一般情況。通過數(shù)據(jù)的收集、統(tǒng)計和分析,評估兩組資料的差異,得出初步結(jié)論。結(jié)果:1.膝關節(jié)KSS功能評分方面,兩組術前評分分別為53.03±4.80和52.90±4.54,統(tǒng)計學分析無顯著統(tǒng)計學差異(P0.05);術后3d治療組評分為68.93±3.22,對照組評分為67.47±1.50,術后3d的KSS評分差異具有統(tǒng)計學意義(P0.05)。術后7d治療組評分為81.40±2.79,對照組評分為79.73±3.47,術后7d的KSS評分差異具有統(tǒng)計學意義(P0.05)。術后14d治療組評分為87.97±2.09,對照組評分為87.10±2.17,術后14d的KSS評分差異無統(tǒng)計學意義(P0.05)。2.疼痛VAS評分方面,兩組術前評分分別為7.00±0.95和7.07±0.91,統(tǒng)計學分析無顯著統(tǒng)計學差異(P0.05);術后3d治療組評分為4.13±0.90,對照組評分為3.87±0.90,術后3d的VAS評分差異無統(tǒng)計學意義(P0.05)。術后7d治療組評分為3.43±0.50,對照組評分為3.37±0.49,術后7d的VAS評分差異無統(tǒng)計學意義(P0.05)。術后14d治療組評分為3.03±0.49,對照組評分為2.90±0.55,術后14d的VAS評分差異無統(tǒng)計學意義(P0.05)。3.匹茲堡睡眠評分方面,兩組術前睡眠評分分別為9.93±2.45和10.30±2.55,統(tǒng)計學分析無顯著統(tǒng)計學差異(P0.05)。術后14d兩組評分均有明顯改善,治療組評分差值為3.70±2.02,對照組評分差值為2.37±2.87,睡眠評分差值兩組對比具有統(tǒng)計學意義(P0.05)。4.并發(fā)癥發(fā)生方面,治療組患者30例中,5例出現(xiàn)患肢腫脹,2例出現(xiàn)患肢僵硬,并發(fā)癥發(fā)生率23.33%,對照組患者30例中,8例出現(xiàn)患肢腫脹,3例出現(xiàn)患肢僵硬,并發(fā)癥發(fā)生率36.67%。無感染、切口延遲愈合、深靜脈血栓等其他并發(fā)癥發(fā)生。5.術后排氣時間方面,治療組排氣時間為9.70±3.72小時,對照組排氣時間為18.4±4.12小時,排氣時間差異具有顯著統(tǒng)計學意義(P0.01)。6.術后下地時間方面,治療組術后下地時間為2.23±0.82天,對照組術后下地時間為2.93± 1.17天,術后下地時間差異有顯著統(tǒng)計學意義(P0.01)。7.住院費用方面,治療組住院費用為70854.68±8068.11元,對照組住院費用為76286.52±6483.30元,住院費用差異有顯著統(tǒng)計學意義(P0.01)。結(jié)論:在全膝關節(jié)置換術后應用中醫(yī)特色療法可促進膝關節(jié)功能康復,促進胃腸功能恢復,改善睡眠,縮短下地時間,減少住院費用。中醫(yī)特色療法進一步促進快速康復外科對術后康復的療效,適合在臨床應用。
[Abstract]:Objective: to total knee arthroplasty patients as the research object, combined with rapid rehabilitation surgery, application of TCM therapy, scores of patients with knee joint function were observed after surgery, pain score and other specialist and exhaust time, ambulation time, difference in sleep quality in general and the control group, observation combined with rapid rehabilitation surgery on the safety and efficacy of total knee arthroplasty in patients with the therapy of Chinese medicine, so as to promote the rehabilitation of patients after total knee arthroplasty. Methods: from February 2016 to February 2017 in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine Department of joint for total knee arthroplasty and met the inclusion criteria of 60 patients who were randomly assigned to treatment group and. The control group, the two groups are subject to rapid rehabilitation surgery model, treatment group with TCM therapy (auricular plaster therapy, acupoint application, Wu Zhuyu hot pack). The two groups of patients by The same group of medical team in accordance with the same surgical approach (anterior median incision of the skin, the patella medial incision capsulotomy, posterior cruciate ligament replacement knee prosthesis replacement of the patella) for unilateral total knee arthroplasty. The general data of two groups of patients were statistically analyzed to determine the general ratio of. There was no significant difference in baseline data, consistent with comparable records. The knee joint function of two groups of patients with postoperative pain score, score of college and exhaust time, ambulation time, sleep quality generally. Through data collection, statistics and analysis, differences in the assessment of two sets of data, draw preliminary conclusions. Results: 1. KSS knee function score, two groups preoperative scores were 53.03 + 4.80 and 52.90 + 4.54, no statistically significant statistical difference (P0.05); postoperative 3D score was 68.93 + 3.22 treatment group, control group 璇勫垎涓，

本文編號：1682784