發(fā)布時間：2018-03-29 20:48

  本文選題：全膝關(guān)節(jié)置換　切入點：中醫(yī)特色療法　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:以全膝關(guān)節(jié)置換術(shù)后患者為研究對象,結(jié)合快速康復(fù)外科,應(yīng)用中醫(yī)特色療法,觀察手術(shù)后患者膝關(guān)節(jié)功能評分、疼痛評分等�？魄闆r以及排氣時間、下地時間、睡眠質(zhì)量等一般情況與對照組的差別,觀察中醫(yī)特色療法結(jié)合快速康復(fù)外科應(yīng)用于全膝關(guān)節(jié)置換術(shù)后患者的有效性及安全性,從而促進(jìn)全膝關(guān)節(jié)置換術(shù)后患者康復(fù)。方法:選取2016年2月起至2017年2月在廣州中醫(yī)藥大學(xué)第三附屬醫(yī)院關(guān)節(jié)科行人工全膝關(guān)節(jié)置換并符合納入標(biāo)準(zhǔn)的患者60人。隨機(jī)分配為治療組及對照組,兩組均實行快速康復(fù)外科模式,治療組再配合中醫(yī)特色療法(耳穴壓籽、穴位貼敷、吳茱萸熱包)。兩組病人均由同一組醫(yī)療團(tuán)隊按照同一手術(shù)方式(膝前正中切口切開皮膚,經(jīng)髕骨內(nèi)側(cè)切口切開關(guān)節(jié)囊,后交叉韌帶替代型膝關(guān)節(jié)假體)行不置換髕骨的單側(cè)人工全膝關(guān)節(jié)置換術(shù)。對兩組患者一般資料進(jìn)行對比及作統(tǒng)計學(xué)分析,確定一般資料無統(tǒng)計學(xué)差異,基線水平一致,具有可比性。記錄兩組患者術(shù)后膝關(guān)節(jié)功能評分、疼痛評分等�？魄闆r以及排氣時間、下地時間、睡眠質(zhì)量等一般情況。通過數(shù)據(jù)的收集、統(tǒng)計和分析,評估兩組資料的差異,得出初步結(jié)論。結(jié)果:1.膝關(guān)節(jié)KSS功能評分方面,兩組術(shù)前評分分別為53.03±4.80和52.90±4.54,統(tǒng)計學(xué)分析無顯著統(tǒng)計學(xué)差異(P0.05);術(shù)后3d治療組評分為68.93±3.22,對照組評分為67.47±1.50,術(shù)后3d的KSS評分差異具有統(tǒng)計學(xué)意義(P0.05)。術(shù)后7d治療組評分為81.40±2.79,對照組評分為79.73±3.47,術(shù)后7d的KSS評分差異具有統(tǒng)計學(xué)意義(P0.05)。術(shù)后14d治療組評分為87.97±2.09,對照組評分為87.10±2.17,術(shù)后14d的KSS評分差異無統(tǒng)計學(xué)意義(P0.05)。2.疼痛VAS評分方面,兩組術(shù)前評分分別為7.00±0.95和7.07±0.91,統(tǒng)計學(xué)分析無顯著統(tǒng)計學(xué)差異(P0.05);術(shù)后3d治療組評分為4.13±0.90,對照組評分為3.87±0.90,術(shù)后3d的VAS評分差異無統(tǒng)計學(xué)意義(P0.05)。術(shù)后7d治療組評分為3.43±0.50,對照組評分為3.37±0.49,術(shù)后7d的VAS評分差異無統(tǒng)計學(xué)意義(P0.05)。術(shù)后14d治療組評分為3.03±0.49,對照組評分為2.90±0.55,術(shù)后14d的VAS評分差異無統(tǒng)計學(xué)意義(P0.05)。3.匹茲堡睡眠評分方面,兩組術(shù)前睡眠評分分別為9.93±2.45和10.30±2.55,統(tǒng)計學(xué)分析無顯著統(tǒng)計學(xué)差異(P0.05)。術(shù)后14d兩組評分均有明顯改善,治療組評分差值為3.70±2.02,對照組評分差值為2.37±2.87,睡眠評分差值兩組對比具有統(tǒng)計學(xué)意義(P0.05)。4.并發(fā)癥發(fā)生方面,治療組患者30例中,5例出現(xiàn)患肢腫脹,2例出現(xiàn)患肢僵硬,并發(fā)癥發(fā)生率23.33%,對照組患者30例中,8例出現(xiàn)患肢腫脹,3例出現(xiàn)患肢僵硬,并發(fā)癥發(fā)生率36.67%。無感染、切口延遲愈合、深靜脈血栓等其他并發(fā)癥發(fā)生。5.術(shù)后排氣時間方面,治療組排氣時間為9.70±3.72小時,對照組排氣時間為18.4±4.12小時,排氣時間差異具有顯著統(tǒng)計學(xué)意義(P0.01)。6.術(shù)后下地時間方面,治療組術(shù)后下地時間為2.23±0.82天,對照組術(shù)后下地時間為2.93± 1.17天,術(shù)后下地時間差異有顯著統(tǒng)計學(xué)意義(P0.01)。7.住院費用方面,治療組住院費用為70854.68±8068.11元,對照組住院費用為76286.52±6483.30元,住院費用差異有顯著統(tǒng)計學(xué)意義(P0.01)。結(jié)論:在全膝關(guān)節(jié)置換術(shù)后應(yīng)用中醫(yī)特色療法可促進(jìn)膝關(guān)節(jié)功能康復(fù),促進(jìn)胃腸功能恢復(fù),改善睡眠,縮短下地時間,減少住院費用。中醫(yī)特色療法進(jìn)一步促進(jìn)快速康復(fù)外科對術(shù)后康復(fù)的療效,適合在臨床應(yīng)用。
[Abstract]:Objective: to total knee arthroplasty patients as the research object, combined with rapid rehabilitation surgery, application of TCM therapy, scores of patients with knee joint function were observed after surgery, pain score and other specialist and exhaust time, ambulation time, difference in sleep quality in general and the control group, observation combined with rapid rehabilitation surgery on the safety and efficacy of total knee arthroplasty in patients with the therapy of Chinese medicine, so as to promote the rehabilitation of patients after total knee arthroplasty. Methods: from February 2016 to February 2017 in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine Department of joint for total knee arthroplasty and met the inclusion criteria of 60 patients who were randomly assigned to treatment group and. The control group, the two groups are subject to rapid rehabilitation surgery model, treatment group with TCM therapy (auricular plaster therapy, acupoint application, Wu Zhuyu hot pack). The two groups of patients by The same group of medical team in accordance with the same surgical approach (anterior median incision of the skin, the patella medial incision capsulotomy, posterior cruciate ligament replacement knee prosthesis replacement of the patella) for unilateral total knee arthroplasty. The general data of two groups of patients were statistically analyzed to determine the general ratio of. There was no significant difference in baseline data, consistent with comparable records. The knee joint function of two groups of patients with postoperative pain score, score of college and exhaust time, ambulation time, sleep quality generally. Through data collection, statistics and analysis, differences in the assessment of two sets of data, draw preliminary conclusions. Results: 1. KSS knee function score, two groups preoperative scores were 53.03 + 4.80 and 52.90 + 4.54, no statistically significant statistical difference (P0.05); postoperative 3D score was 68.93 + 3.22 treatment group, control group 璇勫垎涓，

本文編號：1682784