北京地区全膝关节置换术患者术前预康复实施现状及影响因素分析:多中心横断面调查研究  

Implementation and influencing factors of preoperative rehabilitation in patientsundergoing total knee arthroplasty in Beijing: A multi-center cross-sectional study

作　　者：梁艳彩 崔健 杨旭 李春敏[4] 付俊英 申彦雅 王超[2] 绳宇[1] LIANG Yancai;CUI Jian;YANG Xu;LI Chunmin;FU Junying;SHEN Yanya;WANG Chao;SHEN Yu(School of Nursing,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730;International Medical Services,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730;Department of Orthopedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730;Department of Orthopedics,Beijing Jishuitan Hospital,Beijing 100035;Department of Nursing,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]中国医学科学院北京协和医学院护理学院,北京100730 [2]中国医学科学院北京协和医学院北京协和医院国际医疗部,北京100730 [3]中国医学科学院北京协和医学院北京协和医院骨科,北京100730 [4]北京积水潭医院骨科,北京100035 [5]北京大学国际医院护理部,北京102206

出　　处：《中华骨与关节外科杂志》2021年第11期954-957,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:了解北京地区全膝关节置换术(TKA)患者术前预康复临床开展现状,并分析其影响因素。方法:采用自主设计调查问卷,调查2021年4月1日至5月31日北京3家三级综合医院择期行TKA的患者,分析预康复实施情况及影响因素。结果:研究纳入105例患者,65例(61.9%)患者了解术前预康复,仅33例(31.4%)实施了术前预康复,以居家预康复为主(30例,90.9%)。实施预康复组与未实施预康复组TKA手术患者预康复知晓率差异有统计学意义(P<0.001)。与未实施预康复TKA手术患者相比,实施预康复TKA手术患者病程≥10年、双侧膝关节受累的比例更高,且差异均有统计学意义(P均<0.05)。多元logistic回归结果显示,病程≥10年(OR=2.910,95%CI 1.015~8.344,P=0.047)和双侧膝关节受累(OR=2.933,95%CI 1.016~8.464,P=0.047)是增加TKA手术患者实施预康复的独立因素。结论:目前TKA术前预康复的主要形式是居家预康复,存在患者知晓率不高、实施率低的问题,医护人员应加强预康复宣教并指导患者落实。Objective: To investigate the implementation and influencing factors of preoperative rehabilitation for patientsundergoing total knee arthroplasty(TKA) in Beijing. Methods: A survey was performed by using self-designed questionnaire inpatients undergoing TKA between April 1, 2021 and May 31, 2021 in three top general hospitals in Beijing. Theimplementation and influencing factors of preoperative rehabilitation were analyzed. Results: A total of 105 patients wereenrolled in this survey. Of them, 65 patients(61.9%) were awareness of preoperative rehabilitation, and only 33 patients(31.4%) practiced preoperative rehabilitation which was mainly undertaken at home(30 patients, 90.9%). There wassignificant difference in the awareness rate of preoperative rehabilitation between patients with and without preoperativerehabilitation(P<0.001). The proportion of patients with course of disease ≥10 years and bilateral TKA in preoperativerehabilitation group were significantly higher than those in non-preoperative rehabilitation group(P<0.05). Logisticregression analysis showed that course of disease ≥10 years(OR=2.910, 95%CI: 1.015-8.344, P=0.047) and bilateral TKA(OR=2.933, 95%CI: 1.016-8.464, P=0.047) were independent factors to increase the probability of practicing preoperativerehabilitation in TKA patients. Conclusions: Preoperative rehabilitation is mainly undertaken at home nowadays. Theawareness and implementation of preoperative rehabilitation is not satisfied. It is essential to strengthen propaganda andeducation of preoperative rehabilitation and guide patients to implement it.

关 键 词：全膝关节置换术 术前预康复 横断面调查 

分 类 号：R687.4[医药卫生—骨科学]