摘要
目的全膝关节置换术(TKA)后患者仍有一定程度的不满意率,部分术后功能恢复不良,通过评估专项护理对术后恢复的作用,并分析影响术后功能恢复的主要因素,优化术后护理,促进患者膝关节功能恢复,提高满意率。方法回顾性分析2022年2—7月阜阳市人民医院收治的110例膝关节骨性关节炎患者,根据护理方式不同分为专项护理组(52例)和常规护理组(58例)。比较2组末次随访时患者视觉模拟评分(VAS)、美国特种外科医院膝关节评分(HSS评分)、膝关节活动度(ROM)、并发症发生率、护理满意度等。根据HSS评分将患者分为优良组(HSS≥70分)及不良组(HSS<70分),通过多因素logistic回归分析TKA术后影响膝关节功能的危险因素。结果(1)临床效果:专项护理组较常规护理组VAS评分明显降低(2.08±0.97 vs.3.49±1.10),术后HSS评分和膝关节ROM明显升高(90.24±9.06 vs.84.34±7.36;108.80±8.67 vs.90.45±6.30,P<0.05);(2)护理效果:专项护理组焦虑评分、患者依从性和护理满意度优于常规护理组,且2组比较差异有统计学意义(P<0.05);(3)多因素logistic回归显示,护理方式及年龄、术前HSS评分、术后患者依从性、术后SAS评分等均是TKA术后功能恢复的影响因素(P<0.05)。结论专项护理能减轻TKA术后膝关节疼痛,利于膝关节功能恢复;术后护理方式、年龄、术前HSS评分以及术后患者依从性是TKA术后疗效的独立影响因素。
ObjectiveDespite the presence of patient dissatisfaction following total knee arthroplasty(TKA),some individuals exhibit suboptimal postoperative functional recovery.Through an assessment of the impact of specialized nursing care on postoperative recuperation and an analysis of key factors influencing postoperative functional recovery,it is possible to enhance postoperative care strategies aimed at facilitating the restoration of knee joint function and enhancing patient satisfaction.MethodsA retrospective analysis was conducted on 110 patients with knee osteoarthritis admitted to our hospital from February 2022 to July 2022.The patients were divided into a specialized nursing group(52 cases)and a routine nursing group(58 cases)based on different nursing methods.At the last follow-up,comparisons were made between the two groups in terms of visual analogue scale(VAS),hospital for special surgery knee score(HSS score),range of motion(ROM),complication rate,and nursing satisfaction.Patients were further categorized into an excellent group(HSS≥70)or poor group(HSS<70)according to their HSS scores.Multivariate logistic regression analysis was performed to identify risk factors affecting knee joint function after TKA.Results(1)Clinical effect:The VAS score in the specialized nursing group was significantly lower than that in the routine nursing group(2.08±0.97 vs.3.49± 1.10).Additionally,HSS scores and knee ROM showed significant improvement in the specialized nursing group compared to the routine nursing group(90.24±9.06 vs.84.34±7.36;108.80±8.67 vs.90.45±6.30,P<0.05). (2)Nursing effect:The anxiety score,patient compliance,and overall satisfaction with care were better in the specialized nursing group compared to those in the routine nursing group(P<0.05).(3)Multivariate logistic regression results:nursing style age,preoperative HSS score,postoperative patient compliance,and postoperative SAS score all emerged as influential factors for functional recovery after TKA(P<0.05).ConclusionSpecialized nursing can alleviate knee pain after TKA surgery and promote knee function recovery.The postoperative nursing method,age,preoperative HSS score,and patient compliance after surgery are independent influencing factors affecting the efficacy of TKA.
作者
闫楠
樊昀
YAN Nan;FAN Yun(Department of Orthopedics(Joint and Trauma Ward),Fuyang People's Hospital,Fuyang,Anhui 236000,China;不详)
出处
《中华全科医学》
2024年第9期1619-1622,1630,共5页
Chinese Journal of General Practice
基金
安徽省重点研究与开发计划项目(1704f0804039)
阜阳市科技计划项目(FK202081030)。
