回馈教学在预防中老年全膝关节置换患者术后下肢DVT中的应用  

Application effects of feedback teaching method on the prevention of deep venous thrombosis in middle- aged and elderly patients undergoing total knee arthroplasty

作　　者：魏宁[1] 高婧[1] 张涣悦 邓宝贵[3] 谭益冰[1] 吴小婉[1] Wei Ning;Gao Jing;Zhang Huanyue;Deng Baogui;Tan Yibing;Wu Xiaowan(School of Nursing,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Stomatology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Chin;Department of Orthopedics,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Chin)

机构地区：[1]广州中医药大学护理学院,510006 [2]广州中医药大学附属第一医院口腔科,广州510405 [3]广州中医药大学附属第一医院骨科,广州510405

出　　处：《中华现代护理杂志》2018年第20期2392-2396,共5页Chinese Journal of Modern Nursing

基　　金：广东省科技厅项目（2014A020212556）

摘　　要：目的探讨回馈教学在预防中老年全膝关节置换术后患者下肢DVT中的干预效果。方法采用便利抽样法选取2016年3月—2017年4月入住广州某三级甲等医院骨科的中老年全膝关节置换术后患者96例，按照时间段分组法分为对照组49例和观察组47例。对照组患者接受常规健康教育，观察组患者接受回馈教学教育，比较两组患者功能锻炼依从性、DVT健康知识水平及DVT发生率。结果术后观察组康复锻炼完全依从率80.9%，对照组为44.9%，差异有统计学意（Z=-3.770，P〈0. 01）。观察组DVT健康知识得分（36.34±3.55）分，高于对照组，差异有统计学意义（t=11.676，P〈0.01）。多普勒超声检查显示，观察组中1例患者发生小腿肌间静脉丛血栓；对照组中发生2例髂静脉血流栓塞，2例小腿肌间静脉丛血栓，两组DVT发生率比较差异有统计学意义（Z=-8.477，P〈0.01）。结论回馈教学是一种安全有效的健康教育干预方法，有利于提高中老年全膝关节置换患者术后预防DVT的健康知识和遵医行为，对减少下肢DVT具有重要作用。ObjectiveTo explore the effects of feedback teaching method on preventing deep venous thrombosis （DVT） in middle-aged and elderly patients undergoing total knee arthroplasty （TKA） .MethodsA total of 96 middle-aged and elderly patients who underwent TKA and treated in a ClassⅢ Grade A hospital of Guangzhou from March 2016 to April 2017 were selected in this study using convenience sampling. The participants were divided into two groups based on admission date. The control group received routine health education while the intervention group received feedback teaching. The adherence of functional training, knowledge of DVT, and incidence of DVT were compared between two groups.ResultsThe intervention group had significantly better adherence of rehabilitation training （80.9% vs. 44.9%; Z=-3.770, P〈0.01） and higher scores of DVT knowledge [ （36.34±3.55） vs. （28.36±3.11） ; t=11.676, P〈0.01]compared with the control group. Doppler ultrasonography showed that patients in the intervention group had less incidence of DVT compared with patients in the control group （one case of calf muscular venous plexus thrombosis in the intervention group, two cases of iliac venous blood embolism and two cases of calf muscular venous plexus thrombosis in the control group; Z=-8.477, P〈0.01） .ConclusionsThe feedback teaching method can safely and effectively improve the knowledge of DVT prevention and compliance behavior, and reduce the incidence of DVT in middle-aged and elderly patients with TKA.

关 键 词：关节成形术 置换 膝 深静脉血栓形成 健康教育 回馈教学 功能锻炼 依从性 

分 类 号：R193[医药卫生—卫生事业管理] R687.4[医药卫生—公共卫生与预防医学]