[1]门婷婷,刘桂平.正念减压疗法联合功能锻炼对全膝关节置换患者术后膝关节功能恢复的影响[J].新乡医学院学报,2024,(4):363-368.[doi:10.7683/xxyxyxb.2024.04.012]
　MEN Tingting,LIU Guiping.Effect of mindfulness-based decompression therapy combined with functional exercise on postoperative recovery in patients with total knee arthroplasty[J].Journal of Xinxiang Medical University,2024,(4):363-368.[doi:10.7683/xxyxyxb.2024.04.012]
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正念减压疗法联合功能锻炼对全膝关节置换患者术后膝关节功能恢复的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
期数:
2024年4
页码:
363-368
栏目:
临床研究
出版日期:
2024-04-05

文章信息/Info

Title:
Effect of mindfulness-based decompression therapy combined with functional exercise on postoperative recovery in patients with total knee arthroplasty
作者:
门婷婷1; 2; 刘桂平3
（1.新乡医学院第三临床学院，河南　新乡　453003；2.新乡医学院第一附属医院护理部，河南　卫辉　453100；3.新乡医学院第三附属医院公共卫生科，河南　新乡　453003）
Author(s):
MEN Tingting1; 2; LIU Guiping3
(1.The Third Clinical College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;2.Department of Nursing,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;3.Department of Public Health,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
正念减压; 全膝关节置换术; 功能锻炼; 术后恢复
Keywords:
mindfulness-based decompression; total knee arthroplasty; functional exercise; postoperative recovery
分类号:
R473.6
DOI:
10.7683/xxyxyxb.2024.04.012
文献标志码:
A
摘要:
目的　探讨正念减压疗法联合功能锻炼对全膝关节置换（TKA）患者术后膝关节功能恢复的影响。
方法　选择2022年1月至2023年1月于新乡医学院第一附属医院行TKA的126例患者为研究对象，按随机数字表法将患者分为对照组和观察组，每组63例。对照组患者实施常规术后关节功能锻炼，观察组在常规术后关节功能锻炼的基础上联合应用正念减压疗法。术前及术后1、4、8周，应用视觉模拟评分法（VAS）评估2组患者的疼痛程度，焦虑自评量表（SAS）评估2组患者的焦虑程度，匹兹堡睡眠质量指数（PSQI）评估2组患者的睡眠质量，美国膝关节协会评分（KSS)评估2组患者膝关节疼痛、活动度及稳定性，使用关节角度测量尺测量2组患者的主动膝关节活动度（ROM），采用牛津大学膝关节功能评分（OKS）量表评估2组患者的膝关节功能。
结果　对照组患者术后1、4、8周时的VAS、PSQI评分显著低于术前（P<0.05）；对照组患者术后1周SAS评分显著高于术前，术后4、8周SAS评分显著低于术前（P<0.05）。观察组患者术后1、4、8周时的VAS、SAS、PSQI评分均显著低于术前（P<0.05）。对照组和观察组患者术后1、4、8周时的VAS、SAS、PSQI评分均呈逐渐降低趋势（P<0.05）。术前2组患者VAS、SAS、PSQI评分比较差异无统计学意义（P>0.05）。术后1、4、8周，观察组患者的VAS、SAS、PSQI评分均显著低于对照组（P<0.05）。对照组和观察组患者术后1、4、8周时的KSS评分均显著高于术前（P<0.05）；对照组和观察组患者术后1、4、8周时的KSS评分呈逐渐升高趋势（P<0.05）。术前2组患者KSS评分比较差异无统计学意义（P>0.05）；术后1、4、8周，观察组患者KSS评分显著高于对照组（P<0.05）。对照组患者术后1周膝关节ROM显著低于术前，术后4、8周ROM显著高于术前（P<0.05）；观察组患者术后1、4、8周时的膝关节ROM显著高于术前（P<0.05）；对照组和观察组患者术后1、4、8周时的膝关节ROM呈逐渐增大趋势（P<0.05）。术前2组患者ROM比较差异无统计学意义（P>0.05）；术后1、4、8周，观察组患者的ROM显著高于对照组（P<0.05）。对照组和观察组患者术后1、4、8周时的OKS评分均显著低于术前（P<0.05）；对照组和观察组患者术后1、4、8周时的OKS评分呈逐渐降低趋势（P<0.05）。术前2组患者OKS评分比较差异无统计学意义（P>0.05）；术后1、4、8周，观察组患者OKS评分显著低于对照组（P<0.05）。
结论　正念减压疗法联合功能锻炼有利于全膝关节置换术后患者早期疼痛、焦虑及睡眠的改善，也有助患者术后膝关节活动功能早期的恢复。
Abstract:
Objective　To explore the effect of mindfulness-based decompression therapy combined with functional exercise on the recovery of knee joint function after total knee arthroplasty (TKA).
Methods　A total of 126 patients who underwent TKA at the First Affiliated Hospital of Xinxiang Medical University from January 2022 to January 2023 were selected and randomly divided into the control group and the observation group,with 63 patients in each group.Patients in the control group received routine postoperative joint function exercise,while patients in the observation group received a combination of mindfulness-based decompression therapy and routine postoperative joint function exercise.Before surgery and 1,4,and 8 weeks after surgery,the visual analogue scale (VAS) was used to evaluate the pain level of the two groups of patients,the Self-rating Anxiety Scale (SAS) was used to evaluate the anxiety level of the two groups of patients,and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of the two groups of patients,the American Knee Society Score (KSS) was used to evaluate the knee joint pain,range of motion and stability of the two groups of patients,and the joint angle measuring ruler was used to measure the active knee joint range of motion (ROM) of the two groups of patients.In addition,the Oxford University Knee Function Score (OKS) scale was used to evaluate the knee joint function of patients in the two groups.
Results　The VAS and PSQI scores of patients in the control group at 1,4,and 8 weeks after surgery were significantly lower than those before surgery (P<0.05);the SAS scores of patients in the control group at 1 week after surgery were significantly higher than those before surgery,and the SAS scores at 4 and 8 weeks after surgery were significantly lower than those before surgery (P<0.05).The VAS,SAS,and PSQI scores of the patients in the observation group at 1,4,and 8 weeks after surgery were significantly lower than those before surgery (P<0.05).The VAS,SAS,and PSQI scores of the patients in the control group and the observation group showed a gradual decreasing trend at 1,4,and 8 weeks after surgery (P<0.05).There was no statistically significant difference in VAS,SAS and PSQI scores between the two groups before surgery (P>0.05).At 1,4 and 8 weeks after surgery,the VAS,SAS,PSQI scores of the patients in the observation group were significantly lower than those in the control group (P<0.05).The KSS scores of the control group and the observation group at 1,4 and 8 weeks after surgery were significantly higher than those before surgery (P<0.5),and the KSS scores of the control group and the observation group showed a gradual increasing trend at 1,4 and 8 weeks after surgery (P<0.05).There was no statistically significant difference in KSS scores between the two groups before surgery (P>0.05).At 1,4 and 8 weeks after surgery,the KSS scores of patients in the observation group were significantly higher than those in control group (P<0.05).One week after surgery,the knee ROM in the control group was significantly lower than that before surgery,and the ROMs at 4 and 8 weeks after surgery were significantly higher than those before surgery (P<0.05);the knee ROMs in the observation group at 1,4 and 8 weeks after surgery were significantly higher than those before surgery (P<0.05);the knee ROM in the control group and the observation group showed a gradual increasing trend at 1,4 and 8 weeks after surgery (P<0.05).There was no statistically significant difference in ROMs between the two groups before surgery (P>0.05);at 1,4 and 8 weeks after surgery,the ROMs of the observation group were significantly higher than those of the control group (P<0.05).At 1,4 and 8 weeks after surgery,the OKS scores of the control group and the observation group were significantly lower than those before surgery (P<0.05);the OKS scores of the control group and the observation group showed a gradual decreasing trend at 1,4 and 8 weeks after surgery (P<0.05).There was no statistically significant difference in the OKS scores of the two groups before surgery (P>0.05).At 1,4 and 8 weeks after surgery,the OKS scores of the observation group were significantly lower than those of the control group (P<0.05).
Conclusion　Mindfulness-based decompression therapy combined with functional exercise is beneficial for improving postoperative pain,anxiety,and sleep in patients with total knee arthroplasty,as well as for early recovery of knee joint activity function after surgery.

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更新日期/Last Update: 2024-04-05