家庭访视项目与非家庭访视项目在全膝关节置换患者中的应用：一项随机对照试验。

A home visit program versus a non-home visit program in total knee replacement patients: a randomized controlled trial.

机构信息

School of orthopedic, Institute of medicine, Suranaree University of Technology, 111 University Ave, Muang District, Nakhon Ratchasima, Nakhon Ratchasima, 30000, Thailand.

出版信息

J Orthop Surg Res. 2019 Nov 29;14(1):405. doi: 10.1186/s13018-019-1412-6.

DOI:10.1186/s13018-019-1412-6

PMID:31783762

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6884913/

Abstract

BACKGROUND

The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients' satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities.

METHODS

We recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient's satisfaction score as secondary objective. The study was 6 weeks after surgery.

RESULTS

TKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P < 0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P < 0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P < 0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient's satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P < 0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005).

CONCLUSION

Our TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKR-H improves satisfaction after total knee replacement.

TRIAL REGISTRATION

TCTR20190514001.

摘要

背景

全膝关节置换术（TKR）的目标是缓解疼痛、恢复功能和提高生活质量。手术结果与患者满意度无关。WOMAC 评分低尤其是在术后 6 周内和膝关节疼痛与患者不满意有关。为了提高满意度，我们在出院后创建了家庭访视计划（TKR-H）。INHOMESSS 是进行家庭访视活动的理由。

方法

我们招募了 52 例 TKR 患者。4 例 TKR 患者被排除。24 例患者作为家庭访视（TKR-H）组，24 例患者作为非家庭访视（TKR）组。患者的一般人口统计学、疼痛强度评分（VAS）、关节活动度（ROM）、WOMAC、膝关节评分和功能评分作为主要指标进行评估。步态辅助独立的时间和患者满意度评分作为次要指标。研究在术后 6 周进行。

结果

TKR-H 和 TKR 在 WOMAC 评分的均值上有显著差异（分别为 88.29±10.66 和 68.00±12.47，P<0.001）、疼痛评分（VAS）（分别为 6.25±10.13 和 35.67±22.05，P<0.001）、膝关节评分（分别为 81.67±10.08 和 68.38±6.45，P<0.001）、功能评分（分别为 77.83±4.22 和 73.70±7.48，P=0.037）和关节活动度（分别为 107.71±8.47 和 98.17±9.57，P=0.001）。TKR-H 组的患者满意度评分（4.71±0.46）明显高于 TKR 组（4.13±0.45）（P<0.001）和步态辅助独立时间（分别为 2.75±0.99 和 3.71±1.23，P=0.005）。