引用本文:高红,王婷婷,顾海燕.[cn_title][J].[journal_cn_name],2020,[volume]([issue]):53-56.[点击复制]
gaohong,wangtingting,guhaiyan.[en_title][J].[journal_en_name],2020,[volume]([issue]):53-56.[点击复制]
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加速康复理念下的目标管理在膝关节置换围手术期的应用
高红,王婷婷,顾海燕
0
(江苏省南通市第一人民医院)
摘要:
目的 探讨加速康复理念下的目标管理在人工膝关节置换术(total knee arthroplasty,TKA)围手术期的应用效果。方法 选取2016年1月至2017年3月实施TKA手术的45例患者为对照组,围手术期采取的是一系列加速康复护理措施;2017年4月至2018年7月实施TKA手术的45例患者为试验组,围手术期实施目标管理下的加速康复护理措施。比较两组患者术后疼痛、膝关节功能恢复程度、住院时间以及并发症发生率的差异。结果 与对照组相比,试验组患者术后首次下床时间及住院时间[(33.90±9.80)h、(7.13±0.79)d]均低于对照组[(50.90±9.30)h、(12.32±0.81)d],术后第1天膝关节疼痛度低于对照组(2.86±0.45 vs. 4.07±0.38),术后1个月、3个月的膝关节评分高于对照组(66.82±6.92 vs. 50.90±9.30,76.59±5.38 vs. 65.47±5.78),深静脉血栓及膝关节僵硬发生率(0.00%,2.22%)低于对照组(11.11%,15.56%),两组比较差异均有统计学意义(P<0.05)。结论 目标管理在膝关节置换术后加速康复的应用中有助减轻患者术后疼痛,缩短住院时间,促进膝关节功能恢复,减少术后并发症的发生。
关键词:  加速康复  目标管理  膝关节置换  围手术期护理
DOI:
基金项目:南通市科技计划(指令性)项目:全膝关节置换患者围手术期快速康复的流程研究,市级
Application of management by objectives under the concept of accelerated rehabilitation for perioperative patients receiving knee replacement
gaohong,wangtingting,guhaiyan
(Nantong first people''''s Hospital)
Abstract:
Objective To explore the application effect of management by objectives (MBO) under the concept of accelerated rehabilitation in perioperative patients receiving total knee arthroplasty (TKA). Methods Forty-five patients who underwent TKA surgery from January 2016 to March 2017 were enrolled into the control group. During the perioperative period, a series of accelerated rehabilitation nursing interventions was performed. Another 45 patients who underwent TKA surgery from April 2017 to July 2018 were included in the experimental group who were treated with accelerated rehabilitation nursing intervention under MBO. The differences in postoperative pain, knee function recovery, length of stay and incidence rates of complications between the two groups were compared. Results Compared with the patients in control group, the ones in experimental group had shorter time in bed([33.90±9.80] h vs [50.90±9.30] h)and length of stay ([7.13±0.79] d vs [12.32±0.81] d ). And the pain degree of one day in knee was lower than that of the control group(2.86±0.45 vs 4.07±0.38). The knee joint function scores of 1 month, 3 months in experimental group were higher than those of control group(66.82±6.92 vs 50.90±9.30,76.59±5.38 vs 65.47±5.78). The incidence rates of deep vein thrombosis and knee joint stiffness in experimental group(0.00%,2.22%)were lower than those of control group(11.11%,15.56%)respectively significantly (P<0.05). Conclusions The MBO in the application of accelerated rehabilitation after knee replacement may release the postoperative pain, promote knee function recovery and reduce the incidence rates of complications.
Key words:  Accelerated rehabilitation  Management by objectives  Knee replacement  Perioperative nursing

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