实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (7): 762-765.doi: 10.3969/j.issn.1003-9198.2021.07.027

• 护理园地 • 上一篇    下一篇

预康复在重度老年膝关节屈曲畸形病人全膝关节置换术围手术期的应用

李晶晶   

  1. 210029 江苏省南京市,南京医科大学第一附属医院骨科
  • 收稿日期:2020-07-30 出版日期:2021-07-20 发布日期:2021-08-02

Application of prehabilitation during the perioperative period of total knee arthroplasty in the elderly patients with severe flexion deformity

LI Jing-jing   

  1. Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2020-07-30 Online:2021-07-20 Published:2021-08-02

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摘要： 目的 探讨在老年膝关节重度屈曲畸形病人全膝关节置换术(TKA)围手术期运用预康复对病人康复及长期预后的影响。 方法 选取2019年1~12月我院收治的老年膝关节重度屈曲畸形病人30例,按随机数字表法分为研究组(15例)和对照组(15例)。对照组予常规TKA围术期护理支持,研究组予预康复护理支持。对比2组病人入院时、术前及术后7 d焦虑自评量表(SAS)评分、视觉模拟评分(VAS)和简易营养评估精法(MNA-sf)评分以及入院、术前、术后7 d、术后3个月、术后6个月时膝关节功能,包括膝关节活动度(ROM)、徒手肌力检查(MMT)和Muller膝关节稳定性评分,并记录远期疗效,包括日常活动难度(WOMAC)和生存质量量表(SF-36)。 结果 2组病人入院时SAS、VAS、MNA-sf、MMT、Muller膝关节稳定性、WOMAC、SF-36评分及ROM比较,差异无统计学意义(P>0.05),术前及术后7 d,研究组VAS和SAS评分显著低于对照组(P<0.01),MNA-sf评分显著高于对照组(P<0.01);术前、术后7 d、3个月和6个月,研究组ROM和MMT、Muller膝关节稳定性和SF-36评分显著高于对照组(P<0.05),WOMAC评分显著低于对照组(P<0.05)。 结论 TKA围术期给予老年膝关节重度屈曲畸形病人预康复护理支持,可提升其术前营养水平和功能储备,有利于术后膝关节功能的快速康复,提高远期预后。

关键词: 预康复, 重度屈曲畸形, 膝关节功能, 远期疗效, 老年人

Abstract: Objective To explore the effect of prehabilitation during the perioperative period of total knee arthroplasty (TKA) in the elderly patients with severe flexion deformity. Methods A total of 30 elderly patients with severe flexion deformity undergoing TKA in our hospital from January 2019 to December 2019 were selected and divided into study group (15 cases) and control group (15 cases) according to the random number table method. The control group received conventional perioperative nursing support, and the study group received prehabilitation nursing support. All patients received the assessment of the self-rating anxiety score (SAS), visual Analogue scale (VAS) and mini nutritional assessment (MNA-sf), knee range of motion (ROM), hand muscle test (MMT), Muller knee stability score, daily activity difficulty (WOMAC) and quality of life scale (SF-36) at admission, before operation, 7 d, 3 months, and 6 months after surgery. Results There were no significant differences in the scores of SAS, VAS, MNA-sf, MMT, Muller knee joint stability, WOMAC, SF-36 and ROM at admission between the two groups (P>0.05). Before and 7 days after operation, the scores of VAS and SAS in the study group were significantly lower than those in the control group, while the score of MNA-sf was significantly higher than that in the control group (P<0.05). Before operation, 7 days, 3 and 6 months after operation, the scores of ROM, MMT, Muller knee stability and SF-36 in the study group were significantly higher than those in the control group, while the score of WOMAC was significantly lower (P<0.05). Conclusions Prehabilitation nursing support for elderly patients with severe flexion deformity during TKA perioperative period can improve their preoperative nutritional level and functional reserve, which is beneficial to the rapid rehabilitation of postoperative knee joint function and the improvement of long-term prognosis.

Key words: prehabilitation, severe senile flexion deformity, knee joint function, long-term effect, aged

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