膝关节置换术后压迫患膝伸直的护理作用分析及新型气囊压迫装置的研制
发布时间：2018-09-18 07:30
【摘要】：目的:明确膝关节置换术后压迫患膝伸直的护理措施对促进患者功能恢复的积极影响;研制一种防治人工全膝关节置换术后患膝发生伸直障碍的新型气囊压迫装置,以期为患者康复及临床护理工作提供良好而有效的工具。方法:第一部分:病例的回顾性分析选取某三甲医院自2011至2015年间骨科关节组行全膝关节置换术的159例患者病历资料进行回顾性分析,探讨重物压迫的护理方式对防治全膝关节置换术后患膝发生伸直障碍的影响,同时客观评价现有护理器具的不足之处,作为支持本研究的基础。第二部分:国人膝关节几何参数的测量选取2016年5至7月该院住院患者中骨骼发育成熟且正常的成年人200例,其中男、女各100例。每位受测对象分别测量左、右两侧膝关节的外部形态并记录几何参数,从而为新型气囊压迫装置的设计提供数据基础。第三部分:新型气囊压迫装置的设计在膝关节几何参数测量的基础之上,借鉴以往防治关节挛缩的理论原理,设计新型气囊压迫装置,并分析其性能,检测临床实用性。本研究所收集的数据均采用SPSS17.0进行分析,定量资料采用`X±S表示,定性资料采用率和构成比;计数资料采用c2或Fisher确切概率法,非参数秩和检验;计量资料采用t检验,以P0.05认为差异有统计学意义。结果:1.病例的回顾性分析显示:全膝关节置换术后膝关节上方是否行重物压迫对防治患膝伸直障碍的发生比较差异有统计学意义,术后关节上方行重物压迫可减少患膝伸直障碍的发生。2.国人膝关节几何参数的测量结果显示:同一性别左右膝关节几何参数比较无差异,不同性别间膝关节几何参数比较差异有统计学意义,故在装置设计中应区分性别差异。3.依据国人膝关节几何参数测量结果及静态进展性伸展原理,从全新的角度设计了一种新型装置“气囊压迫装置”,并成功申请下国家专利。该装置采用气囊对患膝进行压迫,保证关节与气囊接触面上受力均匀;与气囊连通的压力表,可实时显示气囊对患膝作用力的大小;使用中依据患者个人疼痛耐受情况,逐次、逐日循序渐进地增加压力值,最终达到患膝完全伸直的目的。结论:重物压迫的护理方式对防治全膝关节置换术后患膝发生伸直障碍的作用有效,故术后护理措施对促进患者功能恢复有积极影响;基于国人膝关节几何参数的测量结果,研制的新型气囊压迫装置压力可控,方便监督,舒适度高,临床初步检测该装置使用中可减轻患者康复期的疼痛程度,增加关节活动度,最终达到压迫关节伸直的效果。
[Abstract]:Objective: to determine the positive effect of nursing measures on the functional recovery of patients with knee extension after knee arthroplasty, and to develop a new type of balloon compression device for preventing and treating knee extension disorders after total knee arthroplasty. In order to provide good and effective tools for patient rehabilitation and clinical nursing work. Methods: the first part: the medical records of 159 patients who underwent total knee arthroplasty in orthopaedic joint group from 2011 to 2015 in a third Class A Hospital were retrospectively analyzed. To explore the effect of heavy body compression on the prevention and treatment of knee extension disorder after total knee arthroplasty, and to evaluate objectively the deficiencies of existing nursing instruments as the basis of this study. The second part: from May to July 2016, 200 adult adults with mature and normal bones were selected, including 100 males and 100 females, for the measurement of knee joint geometric parameters. The external shapes of the left and right knee joints were measured and the geometric parameters were recorded to provide a data basis for the design of a new type of air bag compression device. The third part: based on the measurement of the geometric parameters of the knee joint, a new type of air bag compression device is designed based on the previous theory of preventing and treating joint contracture, and its performance is analyzed, and the clinical practicability is tested. The data collected in this study are analyzed by SPSS17.0, the quantitative data are expressed as'X 卤S', the qualitative data are expressed by the rate and composition ratio, the counting data are calculated by using the exact probability method of c 2 or Fisher, the non-parametric rank sum test is used, the measurement data is expressed by t test. P0.05 thought the difference was statistically significant. The result is 1: 1. The retrospective analysis showed that there were significant differences in the prevention and treatment of knee extension disorders after total knee arthroplasty. After operation, the incidence of knee extension dysfunction was reduced by weight compression on the upper part of the joint. The measurement results of Chinese knee joint geometric parameters show that there is no difference between the right and left knee joint geometric parameters in the same sex, and there is statistical significance in the comparison of the knee joint geometric parameters between the different sexes. Therefore, in the design of the device, the gender difference should be distinguished. According to the measurement results of Chinese knee joint geometric parameters and the principle of static progressive extension, a new type of device called air bag compression device was designed from a new angle, and successfully applied for a national patent. The device uses air bags to compress the affected knee to ensure that the joint is evenly loaded on the contact surface of the air bag; the pressure gauge connected with the air bag can display the force of the air bag on the affected knee in real time; and in use, according to the patient's personal pain tolerance, the pressure gauge can be used one by one according to the patient's individual pain tolerance. Step by day step by step increase the pressure value, and finally reach the goal of complete knee straightening. Conclusion: the nursing mode of heavy body compression is effective in preventing and treating knee extension disorder after total knee arthroplasty, so postoperative nursing measures have a positive effect on promoting the recovery of patients' function, based on the measurement results of Chinese knee joint geometric parameters. The pressure of the new kind of air bag compression device is controllable, easy to supervise, and its comfort is high. The clinical preliminary examination can reduce the pain degree of the patient during the recovery period, increase the motion of the joint, and finally achieve the effect of pressing the joint to straighten out.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6
本文编号：2247219
[Abstract]:Objective: to determine the positive effect of nursing measures on the functional recovery of patients with knee extension after knee arthroplasty, and to develop a new type of balloon compression device for preventing and treating knee extension disorders after total knee arthroplasty. In order to provide good and effective tools for patient rehabilitation and clinical nursing work. Methods: the first part: the medical records of 159 patients who underwent total knee arthroplasty in orthopaedic joint group from 2011 to 2015 in a third Class A Hospital were retrospectively analyzed. To explore the effect of heavy body compression on the prevention and treatment of knee extension disorder after total knee arthroplasty, and to evaluate objectively the deficiencies of existing nursing instruments as the basis of this study. The second part: from May to July 2016, 200 adult adults with mature and normal bones were selected, including 100 males and 100 females, for the measurement of knee joint geometric parameters. The external shapes of the left and right knee joints were measured and the geometric parameters were recorded to provide a data basis for the design of a new type of air bag compression device. The third part: based on the measurement of the geometric parameters of the knee joint, a new type of air bag compression device is designed based on the previous theory of preventing and treating joint contracture, and its performance is analyzed, and the clinical practicability is tested. The data collected in this study are analyzed by SPSS17.0, the quantitative data are expressed as'X 卤S', the qualitative data are expressed by the rate and composition ratio, the counting data are calculated by using the exact probability method of c 2 or Fisher, the non-parametric rank sum test is used, the measurement data is expressed by t test. P0.05 thought the difference was statistically significant. The result is 1: 1. The retrospective analysis showed that there were significant differences in the prevention and treatment of knee extension disorders after total knee arthroplasty. After operation, the incidence of knee extension dysfunction was reduced by weight compression on the upper part of the joint. The measurement results of Chinese knee joint geometric parameters show that there is no difference between the right and left knee joint geometric parameters in the same sex, and there is statistical significance in the comparison of the knee joint geometric parameters between the different sexes. Therefore, in the design of the device, the gender difference should be distinguished. According to the measurement results of Chinese knee joint geometric parameters and the principle of static progressive extension, a new type of device called air bag compression device was designed from a new angle, and successfully applied for a national patent. The device uses air bags to compress the affected knee to ensure that the joint is evenly loaded on the contact surface of the air bag; the pressure gauge connected with the air bag can display the force of the air bag on the affected knee in real time; and in use, according to the patient's personal pain tolerance, the pressure gauge can be used one by one according to the patient's individual pain tolerance. Step by day step by step increase the pressure value, and finally reach the goal of complete knee straightening. Conclusion: the nursing mode of heavy body compression is effective in preventing and treating knee extension disorder after total knee arthroplasty, so postoperative nursing measures have a positive effect on promoting the recovery of patients' function, based on the measurement results of Chinese knee joint geometric parameters. The pressure of the new kind of air bag compression device is controllable, easy to supervise, and its comfort is high. The clinical preliminary examination can reduce the pain degree of the patient during the recovery period, increase the motion of the joint, and finally achieve the effect of pressing the joint to straighten out.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6
【参考文献】
相关期刊论文 前10条
1 张景祥;李金松;;人工全膝关节置换术治疗膝骨关节屈曲内翻畸形320例[J];实用中医药杂志;2015年09期
2 杨莉;高丽;刘琦;路茜;张丽;岳颖;;半导体激光治疗仪在全膝关节置换术后病人中的应用[J];护理研究;2015年15期
3 张云颖;张燕;;全膝关节置换术后悬吊抬高屈曲位对患肢肿胀的影响[J];护理研究;2015年03期
4 计忠伟;包倪荣;赵建宁;;人工全膝关节置换术后疼痛原因分析[J];中国骨伤;2014年11期
5 王娇;张玉梅;;冰敷压迫法对全膝关节置换术后早期康复的影响[J];护士进修杂志;2014年22期
6 刘红丽;孙凯;班月敏;金社辉;;人工膝关节置换术后的康复护理体会[J];临床合理用药杂志;2014年31期
7 何翠环;;压腿练习对人工膝关节伸直功能的作用分析[J];当代护士(中旬刊);2014年09期
8 王锴;彭丹丹;林剑浩;;实施临床路径对人工膝关节置换术住院费用的影响分析[J];中国卫生经济;2013年11期
9 卿忠;姚建锋;张育民;许鹏;朱养均;彭侃;;屈曲挛缩畸形全膝关节置换的软组织平衡[J];中国骨与关节损伤杂志;2013年10期
10 李军;毕胜;;静态进展型支具在关节挛缩中的应用进展[J];中国康复医学杂志;2013年08期
相关博士学位论文 前1条
1 李红卫;“智能可调式下肢抬高系统”的研制及在关节置换术后康复的应用研究[D];南京中医药大学;2015年
相关硕士学位论文 前2条
1 孙英;功能锻炼记录表在全膝关节置换术后患者中的应用[D];青岛大学;2015年
2 李梁;国人股骨远端形态的测量及其在全膝关节置换与假体设计中的意义[D];第二军医大学;2012年
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