全膝关节置换术后短期膝关节功能及其影响因素  

Short-term knee function after total knee arthroplasty and related factors

作　　者：王子豪 李昕华[2] 蒋慧萍 郭赛男 梁秋曼 史婷奇[3] WANG Zihao;LI Xinhua;JIANG Huiping;GUO Sainan;LIANG Qiuman;SHI Tingqi(Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210008,China;Division of Sports Medicine and Adult Reconstructive Surgeryg,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China;Department of Nursing,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China;School of Nursing,Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210023,China)

机构地区：[1]南京中医药大学鼓楼临床医学院,江苏南京市210008 [2]南京大学医学院附属鼓楼医院运动医学与成人重建外科,江苏南京市210008 [3]南京大学医学院附属鼓楼医院护理部,江苏南京市210008 [4]南京中医药大学护理学院,江苏南京市210023

出　　处：《中国康复理论与实践》2024年第1期111-118,共8页Chinese Journal of Rehabilitation Theory and Practice

基　　金：南京大学中国医院改革发展研究院课题(No.NDYG2022067);南京市卫生科技发展专项资金项目(No.YKK22074)。

摘　　要：目的调查患者全膝关节置换术出院后短期膝关节功能状况,分析其影响因素。方法采用便利抽样法,2022年12月至2023年4月,将在南京大学医学院附属鼓楼医院行全膝关节置换术即将出院的患者140例作为调查对象。基于文献回顾选定潜在的影响因素,出院前采用一般资料调查表、康复锻炼依从性量表、康复锻炼自我效能量表(SER)、疼痛视觉模拟量表(VAS)、关节活动度进行调查,出院后1个月采用美国特种外科医院膝关节评分(HSS)进行评定。结果共随访130例。患者出院后1个月HSS评分40~82分,平均(70.89±6.26)分。多元线性回归分析显示,体质量指数(B=-0.423,95%CI-0.622~-0.224,P<0.001)及出院前VAS(B=-1.016,95%CI-1.198~-0.113,P=0.028)、康复锻炼依从性(B=0.267,95%CI 0.121~0.413,P<0.001)、SER(B=0.478,95%CI 0.315~0.642,P<0.001)、膝关节屈曲挛缩角度(B=-0.251,95%CI-0.414~-0.088,P=0.003)可影响患者在出院后1个月HSS评分(R2=0.615,F=17.106,P<0.001)。结论全膝关节置换术患者在出院后短期膝关节功能恢复基本良好,但仍有很大上升空间,临床医护人员需针对其影响因素设计并实施相应的干预措施,提高患者术后短期功能。Objective To investigate the short-term knee function recovery of patients undergoing total knee arthroplasty(TKA)after discharge and analyze its related factors.Methods From December,2022 to April,2023,140 adult patients who underwent TKA in Nanjing Drum Tower Hospital and being about to be discharged were selected as the survey subjects using convenient sampling.Potential influencing factors were selected based on a literature review.They were investigated with general information questionnaire,Rehabilitation Exercise Compliance Scale,Self-Efficacy Scale for Rehabilitation Exercise(SER),Visual Analog Scale for pain(VAS),and joint range of motion measurements before discharge,and were investigated with the Hospital for Special Surgery Knee Score(HSS)one month after discharge.Results A total of 130 patients finished follow-up.One month after discharge,the HSS score ranged from 40 to 82,with an average of(70.89±6.26).Multiple linear regression analysis revealed that Body Mass Index(B=-0.423,95%CI-0.622 to-0.224,P<0.001),pre-discharge VAS(B=-1.016,95%CI-1.198 to-0.113,P=0.028),rehabilitation exercise compliance(B=0.267,95%CI 0.121 to 0.413,P<0.001),SER(B=0.478,95%CI 0.315 to 0.642,P<0.001),and knee joint flexion contracture angle(B=-0.251,95%CI-0.414 to-0.088,P=0.003)could influence HSS score one month after discharge(R2=0.615,F=17.106,P<0.001).Conclusion Patients after TKA have recovered well in short time after discharge,however,there is still significant room for improvement.Clinical healthcare providers should design and implement appropriate interventions based on related factors to improve the function.

关 键 词：全膝关节置换术 关节功能 短期康复 康复现状 影响因素 

分 类 号：R684[医药卫生—骨科学]