| Objective:The purpose of this study was to determine the effects of Astragalus fumigation combined with lower extremity motor control exercises on early limb swelling,pain,functional rehabilitation in patients with total knee arthroplasty(TKA),accroding to promoting functional level of blood circulation,reducing swelling and pain degree of knee joints,so as to provide theoretical basis for knee rehabilitation nursing of TKA patients.Methods:Ninety-nine inpatients with severe primary knee osteoarthritis who underwent unilateral TKA for the first time were selected from October 2019 to December 2020.They were randomly divided into three groups:namely control group,test group Ⅰ and test group Ⅱ,with 33 cases in each group.On the basis of routine nursing and treatment,the control group was given quadriceps relaxation and contraction exercise,active knee flexion and extension exercise,continuous passive movement and other lower limb functional exercise.The experimental group Ⅰ was given foot Astragalus wet hot compress therapy for lower limb functional exercise,and the experimental group Ⅱ was given foot Astragalus fumigation therapy for lower limb functional exercise.The three groups of patients were intervened twice a day from the first day after operation,each intervention time was 15-20 minutes,a total of 5 days.The hemodynamic parameters of dorsalis pedis artery and posterior tibial artery were collected before intervention and on the 1st,3rd and 5th day after intervention: FS,FD,FM,Tam,RI,The swelling degree of the affected limb was evaluated by the circumference difference between the affected limb and the healthy limb,and the pain degree of the affected limb during exercise and rest was evaluated by NRs score.Results:Ninety-nine patients were included,including 7 cases of shedding,and a total of 92patients(2 cases of shedding in the control group and 31 cases in the remaining group);In group Ⅰ,3 cases fell off and the other 30 cases fell off;In group Ⅱ,2 cases fell off,and the other 31 cases completed the data collection1.There were no significant differences in gender,age and disease-related data among the three groups(P>0.05).2.Comparison of lower extremity hemodynamic parametersThe hemodynamic parameters of dorsalis pedis artery and posterior tibial artery were measured before intervention,on the 1st,3rd and 5th day after intervention:(1)Hemodynamic parameters of dorsalis pedis artery in healthy and diseased limbsCompared with before intervention,the hemodynamic parameters of dorsalis pedis artery in healthy and affected limbs of the three groups showed an upward trend on the1 st,3rd and 5th day after operation,while the RI level showed a gradual downward trend.Healthy limbs:there was no significant difference in the parameters of the three groups before and on the first day after the intervention(P>0.05);There were significant differences in FS,FD and RI on the 3rd day after operation(P<0.05);There were significant differences in FS,FD,FM and RI on the 5th day after operation(P<0.05).Affected limb:there was no significant difference in blood flow parameters among the three groups before intervention(P>0.05);There were significant differences in FM,FDand FM levels on the first day after operation(P<0.05);There were significant differences in FS,FD,FM,TAM and RI on the 3rd and 5th day after operation(P<0.05).(2)Hemodynamic parameters of posterior tibial artery in healthy and diseased limbsCompared with before intervention,the levels of FS,FD,FM and TAM in the three groups increased on the first day,the third day and the fifth day after operation,while the level of RI decreased gradually.Healthy limbs:there was no significant difference in the parameters of the three groups before and on the first day after the intervention(P>0.05);There were significant differences in FM and Tam levels on the 3rd day after operation(P<0.05);There were significant differences in FS,FD,FM,TAM and RI on the 5th day after operation(P<0.05).Affected limb:there was no significant difference in the levels of parameters before intervention among the three groups(P>0.05),but only the levels of FM and Tam had significant difference on the first day after operation(P>0.05);There were significant differences in the levels of FS,FD,FM and TAM on the 3rd day after operation(P<0.05);There were significant differences in FS,FD,FM,TAM and RI on the 5th day after operation(P<0.05).3.The difference of peripheral diameter between the affected limb and the healthy limb:the difference between the control group and the test group Ⅱ(P=0.003)was statistically significant,but the difference between the control group and the test group Ⅰ(P=0.106)and the test group Ⅰ and the test group Ⅱ(P=0.671)was not statistically significant.4.NRS score:there was significant difference between the control group and the experimental group Ⅱ(P<0.001),but there was no significant difference between the control group and the experimental group Ⅰ(P=0.197)and the experimental group Ⅰ and the experimental group Ⅱ(P=0.074).5.Resting NRS score:there were statistically significant differences between the control group and the test group Ⅱ(P<0.001),and between the test group Ⅰ and the test group Ⅱ(P=0.040),but there was no statistically significant difference between the control group and the test group Ⅰ(P=0.239).6.Range of motion of knee joint:there were statistically significant differences between the control group and the test group Ⅱ(P<0.001),between the test group Ⅰ and the test group Ⅱ(P=0.040),but there was no statistically significant difference between the control group and the test group Ⅰ(P=0.054).7.The incidence of postoperative complications:the incidence of postoperative complications in experimental group Ⅱ(9.67%)<experimental group Ⅰ(20.0%)<control group(38.71%),the difference was statistically significant(P=0.022).Conclusion:1.Astragalus fumigation combined with lower limb functional exercise was found to be more effective in accelerating the blood flow velocity of dorsalis pedis artery and posterior tibial artery both of healthy and affected limbs,and reducing the resistance index of the healthy and affected limbs.2.Astragalus fumigation combined with lower limb functional exercise was found to be more effective in relieving postoperative pain and swelling,improving the mobility rang of knee joint,reducing postoperative complications,and has no adverse reactions,which is worthy of promotion and application in the rehabilitation nursing of TKA patients. |
PDF Full Text Request