自粘型弹力绷带在髌骨骨折术后应用的研究

发布时间：2018-12-16 16:33

【摘要】：目的:使用静脉血栓形成Virchow三要素的相关理论知识,结合人体解剖学以及血液流变学等知识,在髌骨骨折患者术后患肢应用自粘型弹力绑带包扎,观察术后患者下肢深静脉血栓形成的情况、膝关节腔积液的发生几率及程度、膝关节伸屈功能、疼痛程度,对髌骨骨折术后自粘型弹力绷带包扎的影响进行深入分析,能明确其所具有的优势,从而促进其在临床中的推广与应用,更好地满足广大患者的需要[1]。进行深入研究不仅能为髌骨骨折术后自粘型弹力绷带的技术改进起到推动作用,对髌骨骨折术后病人的临床治疗及护理起到指导作用,还能促进髌骨骨折术后患者功能的康复,减少患者住院时间,减少住院费用,提高患者心理及生理满意度,为患者的生命健康提供保障。方法:使用骨科学及血管外科学相关理论知识,结合人体解剖学以及血液流变学等,随机选取2014年1月到2016年7月期间烟台市烟台山医院创伤骨科病房收治的髌骨骨折患者123例,年龄范围在40--50岁之间,采用随机数字表法分成自粘型弹力绷带包扎组(n=57)与普通绷带包扎组(n=66)[2],术后随访35天,除去失随访的患者后,再次随机筛选80名患者,即自粘型弹力绷带包扎组(观察组n=40)与普通绷带包扎组(对照组n=40)进行对比研究。术后分别对两组患者使用相应的绷带包扎,并于术后第2天、7天、14天、35天分阶段对患者的恢复情况(下肢深静脉血栓、膝关节腔积液、膝关节活动度、疼痛标准)进行仔细观察,并认真记录相关信息。收集整理两组患者的研究数据,运用统计学软件SPSS18.0进行数据分析,对使用不同绷带的两组患者的治疗效果进行分析[3]。结果:对照组患者深静脉血栓发生率27.5%(11例),观察组患者深静脉血栓发生率10.0%(4例);对照组患者术后关节腔积液发生率45.0%(18例),观察组患者术后关节腔积液发生率22.5%(9例);AKS评分对比,观察组患者膝关节功能评分平均值在各时间点均高于对照组,且汇总全部数据平均值亦高于对照组;VAS疼痛评分对比,观察组在各时间点平均值及汇总平均值均低于对照组,且术后早期(2天及7天)差异较为显著。通过分析显示观察组患者治疗效果以及治疗安全性明显优于对照组。结论:髌骨骨折病人术后患肢应用弹力绷带包扎的方法在临床应用具有良好的效果,在患者进行髌骨骨折术后常规治疗与护理的基础上,联合使用自粘型弹力绷带既能有效预防髌骨骨折患者术后下肢深静脉血栓的发生,也能减少术后膝关节腔积液的发生,并能促进髌骨骨折术后患者功能的康复,能有效控制术后患者伤口肿胀、疼痛等症状,减少患者住院时间及住院费用,提高患者心理及生理满意度[4]。与使用普通绷带相比,其效果更好,表明了自粘型弹力绷带在髌骨骨折术后应用具有良好的临床效果,优势显著,其发展与应用前景广阔。
[Abstract]:Objective: to use the theoretical knowledge of the three elements of venous thrombosis (Virchow), combined with the knowledge of human anatomy and hemorheology, to apply self-adhesive elastic bandage to the affected limbs of patients with patellar fracture after operation. The formation of deep vein thrombosis in lower extremities, the occurrence rate and degree of effusion of knee joint, the function of extension and flexion of knee joint, the degree of pain, and the effect of self-adhesive elastic bandage on patella fracture were analyzed. It can make clear its advantages and promote its application in clinic, and meet the needs of patients better [1]. The in-depth study can not only promote the technical improvement of the self-adhesive elastic bandage after patellar fracture, but also guide the clinical treatment and nursing of the patients after patellar fracture, and also promote the rehabilitation of the patients after patellar fracture. Reduce the time of hospitalization, reduce the cost of hospitalization, improve the psychological and physiological satisfaction of patients, and provide protection for patients' life and health. Methods: using the theory knowledge of orthopedics and vasopulmonary surgery, combining human anatomy and hemorheology, etc. From January 2014 to July 2016, 123 patients with patellar fracture were randomly selected from the Department of Orthopaedic Trauma of Yantai Mountain Hospital, Yantai City, aged 40-50 years. The random number table method was used to divide the two groups into self-adhesive elastic bandage group (nong57) and normal bandage group (nnn66) [2]. After 35 days of follow-up, 80 patients were randomly selected. The self-adhesive elastic bandage group (observation group n 40) and normal bandage group (control group n 40) were compared. The patients in the two groups were treated with bandage and bandage respectively, and the recovery of the patients (deep vein thrombosis of lower extremity, effusion of knee joint, range of motion of knee joint) was observed on the 2nd, 7th, 14th and 35th day after operation. The pain criteria are carefully observed and the relevant information is carefully recorded. The data of two groups of patients were collected and analyzed by SPSS18.0 software. The therapeutic effects of two groups of patients with different bandages were analyzed [3]. Results: the incidence of deep venous thrombosis in the control group was 27.5% (11 cases) and in the observation group 10.0% (4 cases). The incidence of postoperative articular effusion was 45.0% (18 cases) in the control group and 22.5% (9 cases) in the observation group. Compared with the AKS score, the average value of knee joint function score in the observation group was higher than that in the control group at each time point, and the average value of the total data was also higher than that of the control group. Compared with the VAS pain score, the average value and aggregate average of the observation group at each time point were lower than that of the control group, and the difference in the early postoperative period (2 days and 7 days) was significant. The results showed that the therapeutic effect and safety of the observation group were better than that of the control group. Conclusion: the application of elastic bandage in the patients with patellar fracture after operation has a good effect in clinical application, and on the basis of routine treatment and nursing care of patients with patellar fracture, The combined use of self-adhesive elastic bandages can not only effectively prevent the occurrence of deep venous thrombosis in the lower extremities after patellar fracture, but also reduce the occurrence of postoperative effusion in the knee joint, and promote the functional rehabilitation of patients with patellar fracture after operation. It can effectively control the symptoms of wound swelling and pain, reduce the hospitalization time and hospital expenses, and improve the psychological and physiological satisfaction of the patients [4]. Compared with the conventional bandage, the results show that the self-adhesive elastic bandage has a good clinical effect in the treatment of patellar fracture, and its advantages are significant, and its development and application have a broad prospect.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6

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