全膝关节置换术治疗膝关节周围骨肿瘤的手术配合及护理探讨  

Surgical cooperation and nursing of total knee arthroplasty in the treatment of bone tumors around the knee joint

作　　者：周瑶 贺景国 宋慧敏 ZHOU Yao;HE Jingguo;SONG Huimin(Department of Operation Roo;Department of Orthopedics,Nanchong Central Hospital,Nanchong 637000,Sichuan,China)

机构地区：[1]南充市中心医院手术室,四川南充6370000 [2]南充市中心医院骨科,四川南充6370000

出　　处：《癌症进展》2018年第8期1048-1051,共4页Oncology Progress

摘　　要：目的探讨全膝关节置换术治疗膝关节周围骨肿瘤的手术配合及护理情况,提高技术配合水平。方法回顾性分析102例膝关节周围骨肿瘤患者的临床资料,观察全膝关节置换术后膝关节周围骨肿瘤患者的术中配合情况和对其手术前后的访视结果。结果 102例膝关节周围骨肿瘤患者术后1 h的疼痛评分为(3.31±0.03)分,术后1 d的疼痛评分为(2.78±0.10)分,术后3 d的疼痛评分为(2.40±0.23)分,患者术后1、3 d的疼痛程度均较术后1 h的疼痛程度明显减轻(P﹤0.01);术后,患者的焦虑、抑郁评分分别为(31.10±3.11)分、(33.25±3.07)分,均明显低于术前的(47.10±2.86)分、(49.36±2.27)分(P﹤0.01)。全部患者均获得随访,随访时间为6~12个月。采用美国特种外科医院(HSS)膝关节评分标准对膝关节功能进行评价:优52例,占51.0%(52/102);良50例,占49.0%(50/102);中0例,占0(0/102);差0例,占0(0/102);优良率为100%(102/102)。结论术前进行个体化心理护理,术中密切配合、严格执行操作规程,术后综合护理,可缓解行全膝关节置换术的膝关节周围骨肿瘤患者的心理压力,减轻患者的术后疼痛,促进患者病情的康复。Objective To investigate the surgical cooperation and nursing of total knee arthroplasty in the treatment of bone tumors around the knee joint. Method The clinical data of 102 patients with bone tumor around the knee joint were analyzed retrospectively. The intraoperative cooperation and the results of pre-and post-operation visits of total knee arthroplasty were investigated. Result The pain scores of 102 patients on the 1st hour, the 1st day and the 3rd day were （3.31±0.03）, （2.78±0.10） and （2.40±0.23）, respectively; and the pain scores on the 1st day and the 3rd day were signifi- cantly decreased compared with that on the 1st hour （P〈0.01）. After operation, the scores of anxiety and depression were （31.10±3.11） and （33.25±3.07）, which were significantly lower than those （47.10±2.86） and （49.36±2.27） before the oper- ation （P〈0.01）. All patients completed the follow-up for 6-12 months, American Hospital for Special Surgery （HSS） knee score criteria was used to assess the knee function： 52 （51.0%） cases were excellent, 50 （49.0%） cases were good, 0 （0） cases was medium, 0 （0） cases was poor, and fine rate was 100% （102/102）. Conclusion The patient＇ s psychological pressure and postoperative pain can be relieved by preoperative individualized psychological nursing, the close coordina- tion during the operation, the strict implementation of operating procedures and postoperative comprehensive care, which can also promote the rehabilitation of the disease.

关 键 词：全膝关节置换术 骨肿瘤 膝关节功能 焦虑 抑郁 

分 类 号：R738.2[医药卫生—肿瘤]