整体护理干预在人工膝关节置换术中的应用[摘要]目的探讨整体护理干预对人工膝关节置换术患者康复的影响。方法选取杭州??桐庐县中医院2012年10月～2013年10月行人工膝关节置换术的患者共计60例，将患者随机分为观察组（30例）和对照组（30例）。观察组患者给予围术期整体化护理干预措施，对照组患者给予围术期常规护理措施。观察并比较两组患者术后不同时间视觉模拟疼痛评分（VAS）；比较两组患者术后首次下床时间、睡眠时间、住院时间等生理指标情况；比较两组膝关节HSS评分情况；比较两组患者术后12个月的生活质量评分。结果①两组患者术后即刻疼痛VAS评分差异无统计学意义（P>0.05），而观察组患者术后24、48、72h的VAS评分显著低于对照组，差异有统计学意义（P<0.05）。②观察组患者术后首次下床时间及住院时间与对照组比较，均明显缩短，术后24、48、72h睡眠时间明显较长，差异均有统计学意义（P<0.05）。③观察组患者术后12个月生活质量评分项目饮食、睡眠、精神、对疾病的认知、配合治疗、日常生活、家庭支持等与对照组比较，均明显较高，差异均有统计学意义（P<0.05）。④两组患者HSS评分各级别所占比例比较，差异有统计学意义（P<0.05），观察组功能恢复明显好于对照组。结论整体护理干预模式可提高患者康复效果，改善患者术后生活质量，从而提高人工膝关节置换术的治疗效果。[关键词]整体护理干预；人工膝关节置换术；康复[]R473.6[文献标识码]B[]1673-7210（2014）06（c）-0122-04ApplicationofoverallnursinginterventioninpatientswithkneearthroplastySHENTuying1ZHUYong21.DepartmentofOrthopedicsandTraumatology,HospitalofTraditionalChineseMedicineofTongluCountyinHangzhouCity,Zhe激angProvince,Tonglu311500,China;2.DepartmentofOrthopaedics,FuyangFracturesofTCMHospitalAffiliatetoZhe激angChineseMedicineUniversity,Zhe激angProvince,Fuyang311400,China[Abstract]ObjectiveTodiscusstheeffectsofoverallnursinginterventiononrehabilitationofpatientswithkneearthroplasty.Methods60patientswithkneearthroplastyinHospitalofTraditionalChineseMedicineofTongluCountyinHangzhouCityfromOctober2012toOctober2013wereselectedanddividedintoobservationgroupandcontrolgroup,with30casesineachgroup.Theobservationgroupwastreatedwithperioperativeoverallnursinginterventionmeasures,thecontrolgroupwastreatedwithperioperativeconventionalnursingmeasures.TheVASscoresofdifferenttimebetweenthetwogroupswereobservedandcompared;thebedtime,sleeptime,thehospitalstaysbetweenthetwogroupswereobserved;theHSSscoresbetweenthetwogroupswereobserved;lifequalityscoresof12monthsaftertheoperationbetweenthetwogroupswereobserved.Results①ThedifferenceofVASscoresaftertheoperationbetweenthetwogroupswasnotstatisticallysignificant(P>0.05);VASscoresat24,48,72hoursafteroperationinobservationgroupwerelowerthanthoseincontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).②Thebedtime,hospitalstaysinobservationgroupwereshorter,whilesleeptimeat24,48,72hoursafteroperationwaslongerthanthatincontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).③Thelifequalityscoresofdiet,sleep,spirit,diseasecognition,treatmentcoordination,dailylife,familysupportinobservationgroupwereallhigherthanthoseincontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).④ThedifferenceoftheproportionofHSSscoresatalllevelsbetweenthetwogroupswasstatisticallysignificant(P<0.05),thefunctionalrecoveryinobservationgroupwasobviouslybetterthanthecontrolgroup.ConclusionTheoverallnursinginterventionmodecanimprovetheeffectofrehabilitation,improvepatients'qualityoflifeandthetherapeuticeffectofartificialkneejointreplacement.[Keywords]Overallnursingintervention;Total...