糖尿病患者膝关节置换术35例围手术期护理(1)
[摘要] 目的 探讨糖尿病患者膝关节置换术患者的护理要点。方法 术前要做好健康宣教、心理护理， 术前功能训练；术后加强专科护理，有效镇痛，防止深静脉血栓，预防感染，术后康复训练。结果 35例患者患者入院后血糖控制较好，伤口恢复情况良好，无感染。手术均成功，关节活动度达(110±10)°，34 例患者伤口实现一期愈合，其中l例术后第3天因屈曲强度过大造成膝前切口开裂，导致切口延迟7 d愈合；术后随访6～24个月， 所有患者均可维持正常的肌力和膝关节活动度，膝关节无疼痛，未发生严重并发症，生活均能够自理。生活均能够自理。 结论 膝关节置换术成功与否，护理工作至关重要。要求护士具备扎实的理论基础，专业的康复知识，将健康宣教、心理护理、血糖控制、康复训练贯穿整个护理过程，鼓励患者能积极配合康复训练，才可保证患者的护理高效性。
[关键詞] 糖尿病；膝关节；置换术；围手术期；护理
[中图分类号] R473 [文献标识码] A [文章编号] 1672-4062(2017)02(b)-0147-03
Nursing of 35 Cases of Diabetes Patients with Knee Arthroplasty during the Perioperative Period
KONG Ling-zhi
Department of Joint Orthopedics， General Hospital of Yankuang Group Co. Ltd， Zoucheng， Shandong Province， 273500 China
[Abstract] Objective To discuss the nursing key points of patients with knee arthroplasty. Methods The health education and mental nursing and function training should be done well before operation， and the specificity nursing was enhanced after operation for the effective analgesia thus preventing the deep venous thrombosis and infection. Results After admission， the blood glucose control was better， and the wound recovery was good without infection， and the operations were successful， and the joint activity degree reached (110±10)°， the wound of 34 cases were healed by first intention， including 1 case with knee fore edge dehiscence at 3 d due to excessive buckling strength， thus causing the delayed healing of wound for 7 d， and all patients can maintain the normal myodynamia and range of movement of knee and the knee joint had no pains， and there were no severe complications and all patients could take care of themselves. Conclusion The nursing work is vital to the success of knee arthroplasty， which requires the nurses be equipped with the solid theoretical basis and professional rehabilitation knowledge， put the health education， mental nursing， blood glucose control and rehabilitation training throughout the whole nursing course and encourage the patients actively cooperate with the rehabilitation training， only in these ways can we ensure the effectiveness of nursing of patients.
[Key words] Diabetes； Knee joint； Replacement； During the perioperative stage； Nursing
随着我国经济发展，城乡居民生存年龄越来越大，从而引起慢性关节炎病变发病率逐年升高，目前全国约有1.2亿人正在经受着骨关节炎的折磨[1]，该类患者的生活质量受到显著影响，生活受到严重困扰。膝关节作为人体最大结构复杂的关节，也是全身发病率最高的关节，对运动功能要求较高，引起膝关节病的原因可能有膝关节外伤、退行性膝关节炎及类风湿性关节炎等。人工关节置换术能够缓解膝部疼痛，矫正膝关节畸形，改善膝关节功能状态，是膝关节病最为有效且治疗最彻底的方式。人工关节置换术具有较大创伤及较多的术后并发症，术后疗效不仅与手术适应证、技术水平有关，还取决于围手术期的护理干预[2]。该院2012 年1月—2016 年6月共35 例糖尿病患者进行人工膝关节置换术，骨科护理人员加大患者围手术期的护理措施及康复指导，临床效果满意，现报道如下。, 百拇医药(孔令芝)
[关键詞] 糖尿病；膝关节；置换术；围手术期；护理
[中图分类号] R473 [文献标识码] A [文章编号] 1672-4062(2017)02(b)-0147-03
Nursing of 35 Cases of Diabetes Patients with Knee Arthroplasty during the Perioperative Period
KONG Ling-zhi
Department of Joint Orthopedics， General Hospital of Yankuang Group Co. Ltd， Zoucheng， Shandong Province， 273500 China
[Abstract] Objective To discuss the nursing key points of patients with knee arthroplasty. Methods The health education and mental nursing and function training should be done well before operation， and the specificity nursing was enhanced after operation for the effective analgesia thus preventing the deep venous thrombosis and infection. Results After admission， the blood glucose control was better， and the wound recovery was good without infection， and the operations were successful， and the joint activity degree reached (110±10)°， the wound of 34 cases were healed by first intention， including 1 case with knee fore edge dehiscence at 3 d due to excessive buckling strength， thus causing the delayed healing of wound for 7 d， and all patients can maintain the normal myodynamia and range of movement of knee and the knee joint had no pains， and there were no severe complications and all patients could take care of themselves. Conclusion The nursing work is vital to the success of knee arthroplasty， which requires the nurses be equipped with the solid theoretical basis and professional rehabilitation knowledge， put the health education， mental nursing， blood glucose control and rehabilitation training throughout the whole nursing course and encourage the patients actively cooperate with the rehabilitation training， only in these ways can we ensure the effectiveness of nursing of patients.
[Key words] Diabetes； Knee joint； Replacement； During the perioperative stage； Nursing
随着我国经济发展，城乡居民生存年龄越来越大，从而引起慢性关节炎病变发病率逐年升高，目前全国约有1.2亿人正在经受着骨关节炎的折磨[1]，该类患者的生活质量受到显著影响，生活受到严重困扰。膝关节作为人体最大结构复杂的关节，也是全身发病率最高的关节，对运动功能要求较高，引起膝关节病的原因可能有膝关节外伤、退行性膝关节炎及类风湿性关节炎等。人工关节置换术能够缓解膝部疼痛，矫正膝关节畸形，改善膝关节功能状态，是膝关节病最为有效且治疗最彻底的方式。人工关节置换术具有较大创伤及较多的术后并发症，术后疗效不仅与手术适应证、技术水平有关，还取决于围手术期的护理干预[2]。该院2012 年1月—2016 年6月共35 例糖尿病患者进行人工膝关节置换术，骨科护理人员加大患者围手术期的护理措施及康复指导，临床效果满意，现报道如下。, 百拇医药(孔令芝)