关节外科医生对全膝关节置换术围手术期伸膝迟滞的认知和管理策略:一项质性研究  

Joint surgeons'perceptions and management strategies of knee extension lag in the perioperative period of total knee arthroplasty:a qualitative study

作　　者：仲憬 于博洋 杨延砚[1] 周谋望[1] ZHONG Jing;YU Boyang;YANG Yanyan;ZHOU Mouwang(Department of Rehabilitation Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院康复医学科,北京市100191

出　　处：《中国康复理论与实践》2025年第4期490-496,共7页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨关节外科医生对全膝关节置换患者围手术期伸膝迟滞的认知和诊疗策略。方法2024年6月至7月,采用目的抽样和方便抽样的方法选取北京大学第一医院和北京大学第三医院的17例关节外科医生为研究对象,进行半结构化访谈。采用NVivo 12.0软件对访谈资料进行分析并归纳主题。结果研究共产生4个主题,10个亚主题。主题1为伸膝迟滞的基础知识,包括定义、诊断、发生率;主题2为关节外科医生对伸膝迟滞的态度,包括临床价值和重视程度;主题3为伸膝迟滞对术后功能结局的影响,包括术前伸膝迟滞和术后伸膝迟滞对功能恢复的影响;主题4为伸膝迟滞的管理策略,包括术前康复、手术策略、术后管理。结论伸膝迟滞的规范化诊疗仍需进一步研究,建议在关节外科医生的培训和康复从业人员的早期康复介入工作中,增加并强调相关内容,以提升伸膝迟滞的诊疗水平,并将其作为全膝关节置换术围手术期管理的有益补充。Objective To explore the perceptions,diagnostic criteria and clinical management strategies of joint surgeons regarding perioperative knee extension lag in patients with total knee arthroplasty.Methods From June to July,2024,17 joint surgeons from Peking University the First Hospital and Peking University the Third Hospital were selected as research subjects using purposive and convenience sampling.Semi-structured interviews were conducted.The interview data were analyzed and themes were summarized using NVivo 12.0 software.Results A total of four themes and ten sub-themes emerged from the study.Theme 1 was the basics related to knee extension lag,including definition,diagnosis and incidence.Theme 2 was the attitudes of joint surgeons towards knee extension lag,including clinical value and importance.Theme 3 was the impact of knee extension lag on postoperative functional outcomes,including the impact of preoperative knee extension lag and postoperative knee extension lag on functional recovery.Theme 4 was management strategies for knee extension lag,including preoperative rehabilitation,surgical strategies and postoperative management.Conclusion The standardized diagnosis and treatment of knee extension lag are still required further research.It is recommended that relevant content be added and emphasized in the training of joint surgeons and the early rehabilitation intervention of rehabilitation practitioners to improve the diagnosis and treatment of knee extension lag and to make it a useful addition to the perioperative management of total knee arthroplasty.

关 键 词：关节外科 全膝关节置换术 伸膝迟滞 质性研究 

分 类 号：R687.4[医药卫生—骨科学]