The effect of flexion position maintenance time on Hb,ROM and VAS after total knee arthroplasty
翁惠英 1沈丹丹 1沈佳敏 1丁丽英1
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作者信息
1. 湖州市第一人民医院骨六科,浙江湖州 313000
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摘要
目的 探讨全膝关节置换术(TKA)患者术后屈曲体位维持时间对Hb和ROM、VAS的影响,并分析体位维持时间对患者术后并发症的影响.方法 选择2023年3-11月湖州市第一人民医院收治的110例TKA患者作为研究对象.TKA患者术后均行屈曲体位管理,根据体位维持时间分组,分为6 h组、24 h组、48 h组.比较3组术后7 d时肿胀程度、皮下瘀斑面积;比较3组术后失血量;比较3组术后膝关节活动度及疼痛水平.结果 48 h组术后3 d、5 d Hb水平高于6 h组、24 h组(P＜0.05);48 h组5 d、7 d ROM高于6 h组、24 h组,VAS评分低于6 h组、24 h组(P＜0.05);双变量相关性Tau-b(K)分析结果显示,屈曲体位维持时间与Hb、ROM呈正相关关系(r=0.519、0.491,P＜0.001),屈曲体位维持时间与VAS呈负相关关系(r=-0.494,P＜0.001);3组并发症发生率[48 h组:5.41％(2/37);24 h 组:8.11％(3/37);6 h 组:13.89％(5/36)]比较,差异无统计学意义(P＞0.05).结论 屈曲体位维持48 h可促进TKA患者术后膝关节功能恢复,降低失血量,缓解术后疼痛,同时体位维持时间还与Hb、ROM及VAS呈正相关关系.
Abstract
Objective To investigate the effect of postoperative flexion position maintenance time on Hb,Range of mo-tion(ROM)and visual analogue scale(VAS)in patients undergoing total knee arthroplasty(TKA),and to analyze the effect of position maintenance time on postoperative complications.Methods A total of 110 TKA patients admitted to the First People's Hospital of Huzhou from March to November 2023 were selected as the study subjects.TKA patients were divided into 6 h group,24 h group and 48 h group according to the time of postural maintenance.The swelling de-gree and subcutaneous ecchymosis area of the three groups were compared at 7 days after operation.The postoperative blood loss was compared among the three groups.The postoperative knee joint activity and pain level were compared a-mong the three groups.Results The level of Hb in 48 h group was higher than that in 6 h group and 24 h group at 3 d and 5 d after operation(P＜0.05).The ROM of 5 d and 7 d in 48 h group were higher than those in 6 h group and 24 h group,and the VAS scores were lower than those in 6 h group and 24 h group(P＜0.05).Bivariate correlation Tau-b(K)analysis showed that the duration of flexion position was positively correlated with Hb and ROM(r=0.519,0.491,P＜0.001),and the duration of flexion position was negatively correlated with VAS(r=-0.494,P＜0.001).There was no significant difference in the incidence of complications among the three groups[48 h group:5.41％(2/37);24 h group:8.11％(3/37);6 h group:13.89％(5/36),P＞0.05].Conclusion Forty-eight hours of flexion position main-tenance can promote the recovery of knee joint function,reduce blood loss and relieve postoperative pain in TKA patients.At the same time,the position maintenance time is positively correlated with Hb,ROM and VAS.
关键词
膝关节炎/全膝关节置换术/屈曲体位/体位维持时间
Key words
Knee arthritis/Total knee arthroplasty/Flexion position/Posture maintenance time
维普
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