| Objective:Through the methods of evidence-based nursing and Delphy expert consultation,training program construction of rapid rehabilitation after total knee arthroplasty,patients with total knee replacement in perioperative nursing,the ambulation time for the first time in two groups,species and the number of cases of post-operative complications occurred during hospitalization,and the average recovery time after the patients and hospital costs compared to the best scheme of total knee replacement in patients with rapid recovery,and the implementation of perioperative fast rehabilitation nursing and provide the reference for the Department of orthopedics staff.Method:1.The construction of the programFirst of all,on the basis of systematic review and evaluation of the literature at home and abroad,through expert panel discussion,a preliminary rehabilitation exercise program for total knee arthroplasty patients has been established.Then the Delphi method conducted two rounds of expert consultation,and use the index experts positive coefficient,authority coefficient,variation coefficient,system analysis results of the consultation,to complete the construction of total knee replacement in patients with rapid rehabilitation surgery and functional exercise program.2.Intervention studyMethods a randomized controlled trial was conducted to randomly divided 80 patients who were eligible for total knee arthroplasty into a trial group and a control group.The patients in the experimental group were treated by the rehabilitation exercise program,and the control group was given routine exercise.The general data,postoperative joint function score,joint mobility,pain score,postoperative adverse event,postoperative hospital stay and rehabilitation costs were observed.SPSS22.0 statistical software was used for statistical analysis,with P<0.05 as the difference,with statistical significance.Result:1.Plan construction:construct the fast rehabilitation surgery function training program.Positive coefficients of two expert consultation was 100%;the authority coefficient was0.75;the coefficient of variation of two 0-0.19 and 0-0.17;and the coordination coefficient of the first round of expert consultation was0.212,the coordination coefficient of the second round of expert consultation was 0.490,through X2 test P values are all<0,05.2.Result of intervention:①patients of the two groups in gender,age,nationality,education level,marital status,weight,operative time,HSS score of 1 days before the opration,showed no significant difference(P>0.05)and are comparable.②.Between the two groups,the number of cases of joint stiffness and the occurrence of bad time was statistically significant(P<0.05).③.The two groups of patients with the first time out of bed,postoperative hospital time,postoperative rehabilitation costs were statistically significant(P<0.05).④.Of the two groups had significant difference in knee HSS score between eighth,twelfth groups(P<0.05).⑤.Two groups of patients fourth,eighth,twelfth days after the joint mobility(ROM)between the groups were statistically significant(P<0.05).⑥.The visual analogue scale score(VAS)of the 6.and two groups fourth,eighth,twelfth days after operation was statistically significant(P<0.05).Conclusion:This research uses the method of evidence-based medicine combined with Delphy rating system expert inquiry method,constructs the total knee replacement in patients with rapid rehabilitation surgery exercise plan,and this scheme is applied to clinical time,verify the short-term clinical effect of this scheme,and draws the following conclusions:1.Fast track surgery functional exercises can reduce postoperative pain in patients with total knee replacement,and promote patients to get out of bed early.2.Fast track surgery functional exercises can improve the knee joint function recover and mobility of patients with total knee replacement.3.Fast track surgery can help shorten the length of stay in patients undergoing total knee arthroplasty and reduce hospital costs. |
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