Objective:To investigate the outcomes of integrated care of perioperative patients undergoing total knee arthroplasty.Methods:The nursing data were retrospectively analyzed in 18 patients undergone total knee replacement in our department between March and July of 2017.The holistic care pro-grams for the perioperative patients consisted of psychological support,guided exercise for functional recovery,monitoring over postoperative vital signs,ear-ly functional exercise,management of perioperative pain and infection,control of the incidence of ceeep venous thrombosis and other complications.Visual analogue scale( VAS) and Lequesne index were used to evaluate the pain severity,and Lysholm' s knee scoring system was used to assess the functional re-covery.Results:Psychological support led to the patients with active and optimistic mind towards surgery,and willingness to follow the prescribed functional exercise program.The scoring on VAS,Lequesne index and Lysholm's scale was 1.06±0.64,4.56±2.09 and 68.39 ±13.81 before discharge compared to 4.83±0.71,14.56±3.07 and 26.33±6.54 upon admission,respectively.The difference was significant (P<0.05).All patients were recovered,without wound infection and deep venous thrombosis before discharge.Conclusion:Integrated care for perioperative patients undergoing total knee arthroplasty may relieve the mental pressure,improve the patient' s compliance with treatment and nursing,reduce the pain severity,improve early functional recovery and reduce the incidences of postoperative complications.%目的:探讨人工全膝关节置换术围手术期的护理及效果.方法:回顾性分析2017年3~7月在我科进行人工全膝关节置换术的18例膝关节疾病患者资料.围手术期整体护理主要有心理支持,功能锻炼指导,术后生命体征监测,早期功能锻炼,围手术期疼痛管理,感染、深静脉血栓等并发症预防及护理.采用视觉模拟评估法(VAS)及Lequesne指数评分表评定患者膝关节疼痛情况,采用Lysholm膝关节功能评定量表评定患者膝关节功能恢复情况.结果:心理支持后使患者积极、乐观接受手术,坚持功能锻炼.经围手术期整体护理后,18例患者出院前VAS评分、Lequesne评分、Lysholm评分(1.06±0.64、4.56±2.09、68.39±13.81)与入院时(4.83±0.71、14.56±3.07、26.33±6.54)相比均有改善,差异具有统计学意义(P<0.05).出院前膝关节创口无感染,无下肢深静脉血栓发生,康复出院.结论:规范人工全膝关节置换术围术期护理,可以减轻患者心理负担,促进患者积极配合治疗、护理;同时可以减轻患者疼痛,改善术后膝关节功能,减少手术并发症.
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