膝关节重度屈曲畸形行全膝关节置换术后的康复护理  

Rehabilitation and nursing after total knee arthroplasty in patients with severe flexion contracture

作　　者：王睿[1] 车晓艳[1] 李敏[1] 贺芳[1] 濮红萍[1] 

机构地区：[1]南京大学医学院附属鼓楼医院中西医结合科,210008

出　　处：《护理实践与研究》2012年第3期34-35,共2页Nursing Practice and Research

摘　　要：目的:介绍重度屈曲畸形患者行全膝关节置换术后的康复方法。方法:对80例重度屈曲畸形>60°行全膝关节置换术的患者,术后采用系统的康复方法,按美国特种外科医院(HSS)膝关节功能评分标准,术前膝关节评分为(51.25±6.10)分,康复内容包括:肌力、肌耐力、本体感受功能、活动度、理疗、传统中医推拿疗法、心理护理。通过功能评分、稳定性、肌力、满意度几方面,评价其效果。结果:术后3个月,膝关节肿胀已消除,术后平均1年患膝股四头肌、腘绳肌、腓肠肌肌力均达到Ⅳ级(徒手肌力评定分级)以上。患者主观满意程度高,膝关节功能评分为(87.13±7.43)分,与术前相比,差异有统计学意义。结论:对于重度屈曲畸形行全膝关节置换术后患者,采用该康复方法效果满意。Objective：To introduce rehabilitation after total knee arthroplasty in patients with severe flexion contracture.Methods：80 cases of TKA with knee contractures greater than 60° were instructed postoperatively for rehabilitation for one year.According to HSS knee score scale,the knee function score was 51.25±6.10 preoperative.The program included： muscle strength exercise,muscle resistance,proprioception,range of motion,physiotherapy,TCM therapy,psychotherapy.Through analysis of stability,muscle strength,range of motion,gait.and knee scale score evaluation,the applicability and effectiveness of the nursing program were studied.Results：The tumefaction of the operated knee was regained in all cases three months after surgery.The strength of quadriceps femoris,hamstrings and gastreocnemius all reached Ⅳgrade（MMT） one year after operation.The patients were satisfactory.The total knee score were 87.13±7.43 according to HSS knee score scale.Statistically the difference between the HSS score before and one year after operation has prominent significance.Conclusion：For the patients with severe flexion contracture after TKA this rehabilitation was practical and effective.

关 键 词：关节成形术 置换 膝关节 运动疗法 屈曲畸形 护理 

分 类 号：R473.6[医药卫生—护理学]