李卓惠　张春琼　李凌霄

[摘要]目的 觀察快速康复外科（FTS）理念在膝关节置换术患者护理中的应用效果。方法 选取2017年8月～2019年8月在我院住院行膝关节置换术的90例患者作为研究对象，根据随机数字表法分为两组。对照组（n=45）采取常规护理措施干预，观察组（n=45）在对照组基础上予以FTS理念的护理干预。采用膝关节评分标准（HSS）评估两组术前及术后3周膝关节功能恢复情况，采用视觉模拟评分法（VAS）评估两组术前及术后3周关节疼痛情况，采用自制护理满意度调查问卷表调查两组术后护理总满意度。结果 两组术前HSS及VAS评分比较，差异无统计学意义（P>0.05）;两组术后3周HSS评分高于治疗前，差异均有统计学意义（P<0.05），而两组VAS评分低于治疗前，差异有统计学意义（P<0.05），且观察组术后3周HSS评分高于对照组，VAS评分低于对照组，差异均有统计学意义（P<0.05）。观察组术后护理总满意度（93.33%）高于对照组（71.11%），差异有统计学意义（P<0.05）。结论 在膝关节置换术护理中应用FTS理念可明显改善患者膝关节功能，减轻膝关节疼痛，显著提高护理满意度。

[关键词]快速康复外科;膝关节置换术;膝关节功能;关节疼痛

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）6（c）-0246-04

Application effect of the concept of fast track surgery in the nursing of patients undergoing knee arthroplasty

LI Zhuo-hui   ZHANG Chun-qiong   LI Ling-xiao

Department of Surgery， the People′s Hospital of Huazhou City， Guangdong Province， Huazhou   525100， China

[Abstract] Objective To observe the application effect of the concept of fast track surgery （FTS） in the nursing of patients undergoing knee arthroplasty. Methods A total of 90 patients hospitalized in our hospital from August 2017 to August 2019 for the treatment of knee arthroplasty were selected as the research objects， patients were divided into two groups according to random number table method， the control group （n=45） took routine nursing intervention， and the observation group （n=45） took the concept of FTS nursing intervention on the base of the control group. The recovery of knee joint function in the two groups before and 3 weeks after surgery was evaluated by hospital for special surgery knee rating scale （HSS）. The joint pain in the two groups before and 3 weeks after surgery was evaluated by visual analogue scale （VAS）. The postoperative nursing total satisfaction of two groups was investigated by the nursing satisfaction questionnaire. Results There were no significant differences in HSS and VAS scores between the two groups preoperative （P>0.05）. The HSS score of the two groups 3 weeks after surgery was higher than that before treatment， the difference was statistically significant （P<0.05）， and the VAS score was lower than before treatment， the difference was statistically significant （P<0.05）. In addition， HSS score of the observation group was higher than of the control group after treatment， VAS score of the observation group was lower than that of the control group， the differences were statistically significant （P<0.05）. The postoperative nursing total satisfaction of the observation group （93.33%） was higher than that of the control group （71.11%）， the difference was statistically significant （P<0.05）. Conclusion The application of FTS in the nursing of knee arthroplasty can significantly improve the patients′ knee joint function， alleviate the knee joint pain， and significantly improve the nursing satisfaction.

[Key words] Fast track surgery; Knee arthroplasty; Knee function; Pain of joint

骨关节炎是一种发病率较高的慢性退行性关节病变，包括脊柱关节炎、髋关节炎及膝关节骨关节炎不同类型，其中以膝关节骨关节炎发病率最高[1-2]。膝关节骨关节炎主要见于中老年人群，临床症状表现为关节肿痛不适、关节腔内积液或弹响等，如未得到积极有效治疗，极易出现关节畸形[3-4]。膝关节置换术是目前减轻膝关节疼痛严重程度，矫正关节畸形及改善膝关节生理功能有效方法，但术后易出现关节肿胀及疼痛并发症，使患者术后膝关节生理功能恢复缓慢，出现较多负面情绪，需加强护理干预措施[5-6]。快速康复外科（fast track surgery，FTS）指对围术期各种措施予以优化，明显减轻手术创伤所引起应激反应，明显降低术后并发症发生率、缩短术后住院时间，最终使患者病情迅速康复[7]。本研……