王金玲

【摘要】 目的：探討医护一体化护理模式在全膝关节置换术患者中应用效果。方法：选择2017年12月-2019年12月于本院行全膝关节置换术的患者88例。按随机数字表法分为观察组和对照组，各44例。对照组给予常规护理，观察组给予医护一体化护理。比较两组术后1周及3个月膝关节功能[美国特种外科医院（HSS）]评分、疼痛情况[视觉模拟评分法（VAS）]评分，术后恢复时间（直腿抬高、主动屈曲至90°所用时间）及住院时间，并观察并发症发生情况。结果：术后1周、3个月，观察组HSS评分均高于对照组，VAS评分均低于对照组，差异均有统计学意义（P<0.05）。观察组直腿抬高、主动屈曲至90°所用时间及住院时间均短于对照组，差异均有统计学意义（P<0.05）。观察组并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论：医护一体化护理应用于全膝关节置换术患者能够促进膝关节功能快速康复，改善膝关节功能，减轻术后疼痛程度，降低并发症发生率。

【关键词】 全膝关节置换术 医护一体化护理 膝关节功能 并发症

Influence of Integrated Nursing Care Mode on Promoting Postoperative Rehabilitation of Patients with Total Knee Replacement/WANG Jinling. //Medical Innovation of China， 2021， 18（10）： 0-096

[Abstract] Objective： To explore the application effect of integrated nursing care mode in patients with total knee replacement. Method： A total of 88 patients who underwent total knee arthroplasty in our hospital from December 2017 to December 2019 were selected. According to random number table method， they were divided into observation group and control group， 44 cases in each group. The control group was given routine nursing care， and the observation group was given integrated nursing care. The knee function [（the hospital for special surgery） HSS]score and pain [（visual analogue scale） VAS] score at 1 week and 3 months after operation， the postoperative recovery time （the time for straight leg raising and active flexion to 90°， and hospital stay were compared between the two groups， the incidence of complications was observed. Result： 1 week and 3 months after surgery， the HSS scores of the observation group were higher than those of the control group， and the VAS scores of the observation group were lower than those of the control group， the differences were statistically significant （P<0.05）. The duration of straight leg elevation， active flexion to 90° and hospital stay in the observation group were shorter than those in the control group， the differences were statistically significant （P<0.05）. The complication rate of the observation group was lower than that of the control group， the difference was statistically significant （P<0.05）. Conclusion： The application of integrated nursing care in total knee replacement patients can promote the rapid recovery of knee function， improve knee function， reduce the degree of postoperative pain， and reduce the incidence of complications.

[Key words] Total knee replacement Integrated nursing care Knee function Complications

First-authors address： Zhuanghe Central Hospital， Zhuanghe 116400， China

doi：10.3969/j.issn.1674-4985.2021.10.022

全膝关节置换术是目前治疗膝关节疾病的常用手段，主要适用于膝关节严重畸形、膝关节骨性关节炎等疾病，能够有效缓解患侧关节疼痛，改善关节功能[1]。手术方法是影响患者术后康复效果的因素之一，而合理的护理措施是促进患者膝关节功能恢复、减少并发症发生的关键[2-3]。医护一体化模式是医生及护士共同合作，医护之间保持合理分工、相互协作、密切联系的一种过程，围术期为患者提供一系列已证实有效的方法，以减少患者手术应激及并发症发生，促进患者术后康复[4-5]。本研究将探讨医护一体化护理模式应用于44例行全膝关节置换术的患者，旨在探究其应用效果。现报道如下。

1 资料与方法

1.1 一般资料 选择2017年12月-2019年12月于本院行全膝关节置换术的患者88例。（1）纳入标准：①均符合全膝关节置换术手术指征者;②年龄60～75岁;③均采用全麻联合神经阻滞麻醉方案者。……