摘要
目的:人工膝关节置换术治疗膝关节疾病日益增多,为获得良好的术后效果,对人工膝关节置换术适应症、危险评估因素、手术方法等围手术期相关因素和围手术期康复管理及术后康复干预等方面的进展进行归纳总结。资料来源:应用计算机检索Pubmed数据库1993-01/2004-12的相关文章,检索词“totalkneearthroplasty,totalkneereplacement,rehabilitation”,限定文章语言种类为English,研究对象为人类。同时计算机检索中国期刊全文数据库、万方数据2000-01/2004-12期间的相关文章,检索词″人工膝关节置换术、康复″,限定文章语言种类为中文。资料选择:纳入标准:①关于膝关节置换发展史的研究。②关于人工膝关节假体设计的研究。③关于人工膝关节置换术围手术期的护理与康复的研究。排除标准:较陈旧的文献,重复研究。资料提炼:共收集到589篇与人工膝关节置换术相关的文献,其中20篇符合纳入标准。资料综合:①人工膝关节置换术病例数在逐年上升,其治疗效果已得到充分肯定,但由于手术技术和围手术期管理方法的不同,术后效果也有很大差异,良好的术后效果一定要有良好的围手术期管理和护理与之相适应。②术前要对膝关节进行功能评估,通过录像记录其步行状态,或者应用电子测角仪对膝关节的功能进行定量评估;并收集和评估患者家族情况,居住环境,以利于出院时的综合评定。③术后的康复管理主要是针对防止并发症和功能训练两个方面。术后早期主要的并发症是感染和深静脉血栓;假体松动在术后10～15年假体的松动率为11%～41%。进行实际的高效率的功能训练对预防并发症很重要。结论:成功的手术和高水准的围手术期管理是获得良好的术后效果的关键,进行适当的患者教育、生活指导和实际的高效率的功能训练,对术后患者功能恢复和预防并发症有重要意义。
OBJECTIVE： Along with age of the population advanced and the economy of society developed, the treatment of knee disease by total knee arthroplasty increases increasingly, In order to obtain good postoperative effect, the perioperative risk factors including adaptation syndromes, risk factors and operative methods and the perioperative rehabilitation administration and postoperative rehabilitative interventions were summarized.
DATA SOURCES： An online search of Pubmed database was undertaken to identify relevant articles published in English between January 1993 and December 2004 by using the keywords of ＂total knee arthroplasty, total knee replacement, rehabilitation＂, and the subjects should be human being. Meanwhile, Chinese relevant literatures published between January 2000 and December 2004 were collected from the Chinese journal full-text database and Wanfang database, the keywords were ＂total knee arthroplasty, total knee replacement, rehabilitation＂ in Chinese.
STUDY SELECTION： Inclusive criteria：①Literatures were related to the study of the development history of the total knee replacement, ② The study of the design of the artificial knee, ③Literatures were related to the study of rehabilitation and nursing round the operation period. Exclusive criteria： outdated or repetitive study.
DATA EXTRACTION： Totally 589 relevant literatures were collected, and 20 of them were in accordance with the inclusive criteria.
DATA SYNTHESIS： ①The number of cases treated by total knee arthroplasty increases increasingly year by year, and the therapeutic effect has been confirmed, But the postoperative effects also have great differences because of the different operative technique and perioperative administration, and good postoperative effects need good perioperative administration and nursing. ②We should evaluate the knee function before operation and record its image on foot, or quantitatively assess it by electrogoniometry; On the nursing aspect, we should collect and evaluate the household circumstance and living environment for the comprehensive assessment at discharge, ③Postoperative rehabilitation administration is mainly aiming at preventing complications and functional training. The main postoperative complications at early period are infection and deep venous thrombosis. The loose rate of the prosthesis at 10-15 years after operation is 11%-41%, So it is very important to carry, on the high-efficiency practical functional training.
CONCLUSION： The successful operation and high standard perioperative administration are the key points for the good postoperative effect. The suitable education, living guidance and high-efficiency practical functional training are of significance for the postoperative functional recovery and prevention of complication.
出处
《中国临床康复》
CAS
CSCD
北大核心
2006年第4期134-138,共5页
Chinese Journal of Clinical Rehabilitation
