Department of Operation, Wuhan Fourth Hospital (Puai Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology), Wuhan, Hubei, China 430000.
Department of Sport Medicine, Wuhan Fourth Hospital (Puai Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology), Wuhan, Hubei, China 430000.
Comput Math Methods Med. 2022 Apr 15;2022:2915157. doi: 10.1155/2022/2915157. eCollection 2022.
To explore the effect of nursing in operating room combined with intraoperative heat preservation intervention on preventing incision infection and improving hemodynamics in patients with anterior cruciate ligament (ACL) injury and reconstruction under knee arthroscopy.
About 200 patients with knee arthroscopic ACL reconstruction in our hospital from January 2019 to July 2021 were enrolled. The patients were randomly assigned into two groups: the control group and the study group. The former group received nursing care in the operating room operating room and the latter group received nursing care in operating room combined with intraoperative heat preservation intervention. Nursing satisfaction, incidence of incision infection, knee joint VAS score, knee joint range of motion, knee joint Lysholm score, and hemodynamic indexes were compared.
First of all, we compared the nursing satisfaction, the study group was very satisfied in 78 cases, satisfactory in 20 cases, and general in 2 cases, and the satisfaction rate was 100.00%, while in the control group, 445 cases were very satisfied, 20 cases were satisfied, 15 cases were general, and 8 cases were dissatisfied. The satisfaction rate was 82.00%. The nursing satisfaction of the study group was higher compared to the control group ( < 0.05). Secondly, we compared the incidence of incision infection. The incidence of incision infection in the study group was lower compared to the control group ( < 0.05). With regard to the knee joint VAS score, the knee joint VAS score of the study group was lower compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation ( < 0.05). In terms of the range of motion of the knee joint, the range of motion of the knee joint in the study group was higher compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation ( < 0.05). Regarding the knee joint Lysholm score, the knee joint Lysholm score of the study group was higher compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation ( < 0.05). Finally, we compared the hemodynamic indexes. Before nursing, there exhibited no significant difference ( > 0.05). During and after nursing, the indexes of HR and MAP in the study group fluctuated little ( < 0.05).
During the perioperative period of patients with ACL injury and reconstruction under knee arthroscopy, standardized and necessary operating room combined with intraoperative thermal insulation intervention measures should be given, attention should be paid to the management of operating room, and intraoperative thermal insulation intervention should be strengthened. It includes preoperative visit, psychological nursing of patients, strict application of antibiotics before operation, monitoring of air quality in operating room, disinfection and sterilization of surgical instruments, shortening operation time, maintaining body temperature during operation, and paying attention to hand hygiene of medical staff. It plays a supervisory role in promoting the attention of medical staff to the prevention of wound infection, which is beneficial to the healing of surgical wounds of patients. It plays a positive role in enhancing hemodynamic indexes. Comprehensive nursing intervention on the risk factors of each link can effectively prevent postoperative wound infection and strengthen the prognosis and quality of life of patients.
探讨手术室护理联合术中保温干预对预防膝关节镜下前交叉韧带（ACL）损伤及重建患者切口感染、改善血液动力学的影响。
选取我院 2019 年 1 月至 2021 年 7 月收治的 200 例膝关节镜 ACL 重建患者，随机分为对照组和研究组，每组 100 例。前者在手术室接受护理，后者在手术室接受护理联合术中保温干预。比较两组患者的护理满意度、切口感染发生率、膝关节视觉模拟评分（VAS）、膝关节活动度、膝关节 Lysholm 评分和血液动力学指标。
首先，我们比较了护理满意度，研究组非常满意 78 例，满意 20 例，一般 2 例，满意度为 100.00%，而对照组非常满意 445 例，满意 20 例，一般 15 例，不满意 8 例，满意度为 82.00%。研究组的护理满意度高于对照组（<0.05）。其次，我们比较了切口感染的发生率。研究组的切口感染发生率低于对照组（<0.05）。关于膝关节 VAS 评分，研究组术后 2 周、4 周、8 周和 12 周的膝关节 VAS 评分均低于对照组（<0.05）。在膝关节活动度方面，研究组术后 2 周、4 周、8 周和 12 周的膝关节活动度均高于对照组（<0.05）。关于膝关节 Lysholm 评分，研究组术后 2 周、4 周、8 周和 12 周的膝关节 Lysholm 评分均高于对照组（<0.05）。最后，我们比较了血液动力学指标。护理前，两组无明显差异（>0.05）。护理过程中和护理后，研究组的 HR 和 MAP 指标波动较小（<0.05）。
在膝关节镜下 ACL 损伤及重建患者围手术期，应给予规范、必要的手术室联合术中保温干预措施，重视手术室管理，加强术中保温干预。包括术前访视、患者心理护理、术前严格应用抗生素、监测手术室空气质量、手术器械消毒灭菌、缩短手术时间、术中保持体温、注意医护人员手卫生等。对医护人员重视预防伤口感染的风险因素起到监督作用，有利于促进患者手术伤口愈合。对增强血液动力学指标起到积极作用。对各环节的危险因素进行综合护理干预，可有效预防术后伤口感染，增强患者的预后和生活质量。
