[摘要] 目的 探讨关节镜下腓骨长肌腱重建前交叉韧带围术期临床护理及心理干预的临床效果。 方法 选择2014年5月～2015年8月在华北理工大学附属唐山市人民医院行关节镜下腓骨长肌腱重建前交叉韧带术的患者83例，采用随机数字表法将患者分为两组，分别采取围术期临床护理及心理干预（干预组，n=41）和常规护理干预（对照组，n=42），评估两组患者术后的焦虑和抑郁心理状况及膝关节恢复情况。 结果 治疗后干预组焦虑、认识障碍、日夜变化、迟缓、睡眠障碍、绝望感、HAMD总分均明显低于对照组（P < 0.05）；干预组躯体性焦虑、精神性焦虑、HAMA总分均明显低于对照组（P < 0.05）；干预组膝关节恢复等级明显优于对照组（P < 0.05），膝关节功能恢复优良率（92.68%）明显高于对照组（71.43%）（P < 0.05）。 结论 关节镜下腓骨长肌腱重建前交叉韧带围术期临床护理及心理干预对患者的恢复有积极作用。
[关键词] 关节镜；前交叉韧带损伤；临床护理；心理干预
[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2016）05（a）-0174-04
[Abstract] Objective To investigate the clinical effect of perioperative clinical care and psychological intervention in anterior cruciate ligament reconstruction of peroneus longus tendon under arthroscopic. Methods 83 cases of patients underwent anterior cruciate ligament reconstruction of peroneus longus tendon under arthroscopic in Tangshan People's Hospital Affiliated to North China University of Science and Technology from May 2014 to August 2015 were selected， and divided into two groups according to random number table method. Patients in the intervention group （n=41） were given perioperative clinical care and psychological intervention， and patients in the control group （n=42） were given routine nursing intervention. The anxiety and depression status and knee recovery of the two groups were evaluated. Results After treatment， the scores of anxiety， cognitive disturbance， diurnal variation， slow， sleep disorders， hopelessness and HAMD total score in the intervention group were lower than those in the control group， with statistically significant differences （P < 0.05）. The scores of somatic anxiety， psychic anxiety and HAMA total score in the intervention group were lower than those in the control group， with statistically significant differences （P < 0.05）. The knee recovery grade of the intervention group was significantly better than that of the control group （P < 0.05）， and the excellent rate of knee function recovery （92.68%） in the intervention group was significantly higher than that in the control group （71.43%） （P < 0.05）. Conclusion The perioperative clinical nursing and psychological intervention play a positive role for recovery of patients underwent anterior cruciate ligament reconstruction of peroneus longus tendon under arthroscopic.
[Key words] Arthroscopy； Anterior cruciate ligament injury； Clinical care； Psychological intervention
近年来，由车祸、运动等引起的膝关节损伤患者的数量明显升高，其中前交叉韧带（anterior cruciate ligament，ACL）损伤是膝关节损伤中的重要类型。随着医疗技术的进步，临床上治疗ACL损伤的手术方案也越来越成熟[1]。临床上治疗ACL损伤的主要目标是提高重建韧带的稳定性，并促进移植物的血管化[2-3]。关节镜下ACL损伤修复术具有损伤小、并发症率低、恢复快等优势，成为临床上治疗ACL损伤的推荐性治疗方案[4-5]。但值得注意的是，ACL重建术后仍存在发生关节粘连、积血、关节活动受限的危险。因此，在ACL围术期进行科学、合理、细致的临床护理及心理干预是完善治疗效果、降低并发症、促进恢复的必要措施[6]。近年来，华北理工大学附属唐山市人民医院（以下简称“我院”）在临床实践中注重围术期临床护理及心理干预的临床效果较为理想，现总结报道如下：
1 资料与方法
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