|
|
|
| Effect of special care on the effect of total knee arthroplasty and postoperative blood glucose in elderly diabetic patients |
| CHEN Qin* YIN Yuan yuan* HUO Lijuan▲ Dong Yuefu▲ |
| Department of Joint Surgery, the First People′s Hospital of Lianyungang, Jiangsu Province, Lianyungang 222000, China |
|
|
|
Abstract Objective To explore the effect of special nursing on elderly patients with diabetic total knee replacement (TKA). Methods From June 2016 to June 2018, 120 elderly patients with diabetic TKA admitted to the First People′s Hospital of Lianyungang City, Jiangsu Province were selected. According to random alphabet method, the patients were divided into control group and observation group, 60 cases in each group. The control group was given routine nursing intervention, and the observation group was given special nursing intervention based on routine nursing. Comparison of perioperative blood glucose indexes, nursing quality, nursing satisfaction, hospital for special surgery (HSS), knee of motion (ROM), and self-rating anxiety scale (SAS), self-rating depression scale (SDS) score and differences in complications. Results Comparison of glycosylated hemoglobin (HbA1c), blood glucose (2hPG) and fasting blood glucose (FPG) before nursing intervention between the two groups showed no statistically significant differences (P ＞ 0.05); HbA1c, 2 hPG, and FPG were lower in the two groups after the nursing intervention than before the intervention, and the observation group were lower than those in the control group (P ＜ 0.05); efficacy evaluation was performed six months after operation, and the nursing quality, nursing satisfaction, HSS score, and ROM scores of the observation group were higher than those in the control group (P ＜ 0.05); SAS and SDS scores in both groups were lower than those before intervention, and those in the observation group were lower than the control group (P ＜ 0.05); the incidence of complications and TKA revision in the observation group was lower than that in the control group (P ＜ 0.05). Conclusion Special nursing intervention has obvious influence on elderly diabetic TKA patients, which can promote the curative effect, improve the blood sugar level, reduce the incidence of complications, and improve the quality of care.
|
|
|
|
|
|
[1] Lutz MJ，Halliday BR. Survey of current cementing techniques in total knee replacement [J]. Anz Journal of Surgery，2015，72（6）：437-439.
[2] Han ASY，Nairn L，Harmer AR，et al. Early Rehabilitation After Total Knee Replacement Surgery：A Multicenter，Noninferiority，Randomized Clinical Trial Comparing a Home Exercise Program With Usual Outpatient Care [J]. Arthritis Care & Research，2015，67（2）：196-202.
[3] 刘邦忠，钟宗烨.全膝关节置换术后的康复评定[J].上海护理，2017，17（2）：92-95.
[4] 蔡立柏.全膝关节置换术患者恐动症的研究进展[J].重庆医学，2017，46（31）：4435-4437.
[5] 阮雁捷，郭冠军，冯玉，等.糖尿病手术患者麻醉方式对术后感染与血流动力学及血糖的影响[J].中华医院感染学杂志，2017，27（17）：3933-3935.
[6] 吴玉玲，董跃福.持续被动活动及空气压力治疗仪在全膝关节置换术后病人中的应用[J].护理研究，2015（36）：4585-4586.
[7] 马俊，黄泽宇，胡旭栋.糖尿病患者初次全膝置换围手术期安全性及效果评价[J].中华骨科杂志，2014，34（4）：406-410.
[8] 叶欣，刘志伟.心理护理减少糖尿病患者行膝关节置换术住院时间的分析[J].中国医刊，2017，52（1）：85-87.
[9] 吴湘萍，陈晓东.人工全膝关节置换术围手术期护理研究[J].中华全科医学，2016，14（12）：2123-2125.
[10] 张玉梅，何洁，黄萍，等.657例全膝关节置换术患者术后早期活动度对远期活动度的影响[J].第三军医大学学报，2015，37（18）：1886-1888.
[11] 郑红光，黄荣瑛，郑海东，等.TKA后关节线高度变化对膝关节力学特性影响[J].工程力学，2013，30（S1）：298-303.
[12] 董跃福，牟志芳，蒋胜波，等.膝关节有限元解剖模型的构建及其力学分析[J].临床骨科杂志，2015，18（6）：686-692.
[13] 胡杨，董跃福，徐卿荣，等.全膝关节置换股骨假体植入定位参数有限元分析及优化[J].临床骨科杂志，2012， 15（3）：334-338.
[14] 范永峰.晚期类风湿关节炎合并膝关节强直或僵直畸形行人工膝关节置换术[J].中国伤残医学，2015，23（21）：44-45.
[15] 蒿岁雪.分析麻醉手术时肌体应激反应中的血糖变化[J].中国伤残医学，2015（19）：17-18.
[16] 张伟，刘继军，武永刚，等.围手术期高血糖对人工关节置换术后感染影响的研究[J].中国实验诊断学，2016， 20（10）：1754-1756.
[17] 赵振，马保安，龙华，等.糖尿病与人工关节置换术后假体周围感染的相关性研究[J].中国骨与关节杂志，2018， 7（4）：66-71.
[18] 于大淼，廉永云.糖尿病对人工全膝关节置换术围手术期的影响[J].医学综述，2014，20（9）：1686-1688.
[19] 庄腾丰，王华军，郑小飞，等.糖尿病与膝关节置换术后并发症相关性的Meta分析[J].中国矫形外科杂志，2018， 26（15）：1390-1396.
[20] 吕红姣.老年膝关节骨性关节炎患者TKA术后不同护理方式效果观察[J].河北医科大学学报，2012，33（6）：717.
[21] 李娜.全膝关节置换术后康复护理对患者关节肿胀,疼痛的影响[J].中国现代医生，2019，57（25）：155-157. |
|
|
|
