CAJ | 학술논문

目的：探讨全膝关节置换术后肢体肿胀的影响因素及护理对策,以进一步完善围术期肢体康复训练。方法对2013年4—10月接受全膝关节置换术的183例患者进行回顾性分析,比较不同性别、年龄、身高体质量指数( BMI)、术前诊断、麻醉方式、术后抗凝方式、止血带使用时间、围术期血红蛋白变化、假体类型等对术后肢体肿胀程度的影响。采用 SPSS 16.0统计软件包对数据进行分析。结果比较BMI≤25 kg/m2患者与BMI>25 kg/m2患者全膝关节置换术后膝上10 cm周径变化值时发现,两者差异具有统计学意义(t=-0.270,P<0.05)；根据年龄分为<60岁、60~70岁和>70岁3组,三组间术后肢体肿胀差异无统计学意义(P>0.05)；将止血带使用时间与肢体肿胀程度进行Pearson相关分析,发现两者无相关性(P>0.05)。性别、麻醉方式、抗凝方式等对术后肢体肿胀均无影响(P>0．05)。二分变量线性回归分析结果表明,TKA术后肢体肿胀的影响因素包括BMI、围术期血红蛋白变化值及假体类型(P<0.05)。结论全膝关节置换术后早期肢体肿胀容易发生,其肿胀程度与患者BMI、围术期血红蛋白变化及假体类型呈相关性,应制定个体化护理对策,减轻患者术后肢体肿胀,优化患者康复训练效果。
목적：탐토전슬관절치환술후지체종창적영향인소급호리대책,이진일보완선위술기지체강복훈련。방법대2013년4—10월접수전슬관절치환술적183례환자진행회고성분석,비교불동성별、년령、신고체질량지수( BMI)、술전진단、마취방식、술후항응방식、지혈대사용시간、위술기혈홍단백변화、가체류형등대술후지체종창정도적영향。채용 SPSS 16.0통계연건포대수거진행분석。결과비교BMI≤25 kg/m2환자여BMI>25 kg/m2환자전슬관절치환술후슬상10 cm주경변화치시발현,량자차이구유통계학의의(t=-0.270,P<0.05)；근거년령분위<60세、60~70세화>70세3조,삼조간술후지체종창차이무통계학의의(P>0.05)；장지혈대사용시간여지체종창정도진행Pearson상관분석,발현량자무상관성(P>0.05)。성별、마취방식、항응방식등대술후지체종창균무영향(P>0．05)。이분변량선성회귀분석결과표명,TKA술후지체종창적영향인소포괄BMI、위술기혈홍단백변화치급가체류형(P<0.05)。결론전슬관절치환술후조기지체종창용역발생,기종창정도여환자BMI、위술기혈홍단백변화급가체류형정상관성,응제정개체화호리대책,감경환자술후지체종창,우화환자강복훈련효과。
Objective To investigate the nursing strategy and related factors for limb swelling after total knee arthroplasty ( TKA) for furtherly guiding and improving rehabilitation of patients in our clinical work. Methods A total of 183 patients, who underwent TKA during April to October 2013, were retrospective analysis and compared gender, ages, body mass index ( BMI ) , diagnosis before operation, the method of anesthesia, anticoagulation method, the using time of tourniquet, perioperative change of hemoglobin and type of prosthesis impacting on limb swelling after operation. All data were analyzed by SPSS 16. 0. Results Compared patients with BMI≤25 kg/m2 and those with BMI >25 kg/m2 , there was statistical difference on patients′circumference of 10 cm above knee (t= -0. 270,P<0. 05), but no significant differences among patients <60 years, 60 - 70 years and > 70 years ( P > 0. 05 ), the same as gender, the method of anesthesia, anticoagulation method having no impact on limb swelling (P>0. 05). The time of using tourniquet had no correlation with limb swelling by Pearson correlation analysis (P >0. 05). By two variable linear regression analysis, it represented that the effects of limb swelling including BMI, perioperative hemoglobin values and prosthesis type (P<0. 05). Conclusions Limbs swelling is easy to occur within the early postoperative period of TKA. Lower extremity swelling is related on BMI, perioperative hemoglobin values, and prosthesis type to some extent. Individualized nursing measures should be formulated to reduce postoperative limb swelling, and optimize patient rehabilitation training.