【摘要】 目的观察早期康复护理介入对膝关节置换患者术后下肢深静脉血栓(DVT)形成和下肢功能恢复的影响。方法将90例行人工全膝关节置换术(TKA)患者随机按信封法分为对照组(45例)和观察组(45例),术后对照组给予常规护理,观察组在对照组基础上给予早期康复护理,比较术前及术后14d2组血清D-二聚体、纤维蛋白降解产物(FDPs)水平、下肢彩色多普勒超声、数字分级法疼痛评分(NRS)、美国膝关节协会评分(KSS)、膝关节活动度(ROM)、Barthel指数(BI)评分变化。结果术后14d,观察组血清D-二聚体、FDPs水平明显低于对照组(P<0.05),股总静脉血流峰值明显高于对照组(P<0.05)。观察组无DVT发生,对照组有2例DVT发生,2组比较差异无统计学意义(P>0.05);但观察组浅静脉血栓(SVT)发生率明显低于对照组(P<0.05)。术后14d,观察组较对照组NRS评分明显降低,ROM、HSS、BI评分明显升高,差异有统计学意义(P<0.05)。结论早期康复护理介入可改善下肢血液循环,有助于预防下肢DVT形成,并促进下肢功能恢复。更多还原

【Abstract】 Objective To observe the effect of early rehabilitation nursing intervention on lower limb deep venous thrombosis(DVT)and the recovery of lower limb function in patients after total knee arthroplasty(TKA).Methods Ninety patients undergoing TKA were randomly divided into the control group(45 cases)and the observation group(45 cases).The control group was given routine nursing after surgery while the observation group was given early rehabilitation nursing.Changes in levels of serum D-dimer and fibrinogen degradation products(FDPs),color Doppler ultrasonography of lower limbs,numeric rating scales(NRS)scores of lower limb pain,the American Knee Society score(KSS),knee range of motion(ROM)and Barthel index(BI)scores before surgery and at 14 dafter surgery were compared between the two groups.Results Serum levels of D-dimer and FDPs in the observation group were significantly lower than those in the control group at 14 dafter surgery(P <0.05),and the peak of femoral venous blood flow was significantly higher than that of the control group(P <0.05).There was no DVT in the observation group while there were 2 cases of DVT in the control group(P >0.05).The incidence of superficial vein thrombosis(SVT)in the observation group was significantly lower than that in the control group(P <0.05).The NRS score in the observation group was significantly lower while scores of ROM,HSS and BI were significantly higher than those in the control group at 14 dafter surgery(P <0.05).Conclusion Early rehabilitation nursing intervention can improve the blood circulation of lower limbs,which is good for preventing lower limb DVT and promoting the recovery of lower limb function.更多还原