摘要
目的:探讨行膝关节恶性骨肿瘤关节置换术围手术期的护理干预方式,提出减少全膝关节置换术后并发症,提高手术疗效,提高患者生活质量的临床护理策略。方法:将北京积水潭医院骨肿瘤科120例诊断为膝关节恶性骨肿瘤需行全膝关节置换术的患者按完全随机分组方式分成护理I组和护理II组,两组均接受膝关节肿瘤围术期常规临床护理,其中II组加用北京积水潭医院骨肿瘤科改进的全膝肿瘤患者护理干预措施,比较分析2组Ennking骨骼肌肉肿瘤下肢评分量表(musculoskeletal t u m o rr a t i n gs c a l e, M S T S)评分、术后并发症的发生率及护理前后抑郁自评量表(S e l f-R a t i n g Depression Scale,SDS)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、匹兹堡睡眠质量指数量表(Pittsburghsleepqualityindex,PSQI)评分。结果:II组MSTS评分明显优于I组(P<0.05),感染、深静脉血栓、膝关节强直、肌肉萎缩等并发症发生率显著低于I组(P<0.05);SDS,SAS,PSQI评分也优于I组(P<0.05)。结论:对膝关节恶性骨肿瘤需行全膝关节置换术的患者进行骨科术后临床护理,并在此基础上进行患者个性化心理疏导等综合护理干预,可有效减少置换术后并发症,提高术后疗效,改善骨肿瘤患者生活质量。
Objective: To investigate the perioperative nursing strategies of patients with malignant tumor of bone received total knee arthroplasty, and put forward nursing strategies in order to reduce complications after joint replacement, improve the surgical curative effect and to improve the life quality of patients. Methods: One hundred and twenty patients diagnosed with knee malignant bone tumors who need total knee arthroplasty in our hospital were completely randomly divided into I group and II group. The patients in the I/II group received conventional clinical nursing, while the patients in the II group received special nursing intervention. The Ennking Musculoskeletal Tumor Rating Scale(MSTS) score, the incidence of postoperative complications, SelfRating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), Pittsburgh sleep quality index(PSQI) score were evaluated. Results: In the II group, the MSTS score was better than I group, the incidence of complications including infection, deep vein thrombosis, knee joint stiffness, muscle atrophy was significantly lower than I group(P<0.05). SDS, SAS, PSQI score in the experimental group was superior to I group(P<0.05). Conclusion:The special perioperative nursing of patients with malignant tumor of bone received total knee arthroplasty can effectively reduce the incidence of complications, the curative effect and improve the patients' quality of life.
引文
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