摘要
背景:全膝关节置换术(TKA)后营养不良是备受关节外科医师关注的一个问题。TKA术后营养不良会增加术后并发症、延长住院时间、延缓患者回归社会。目的:对比多模式营养管理与传统营养管理对老年患者TKA术后营养不良、电解质紊乱的影响。方法:前瞻性选择2017年9月至2018年3月拟行单侧TKA的100例老年患者。依据随机数字表均分为多模式营养管理组(MNM组)和传统营养管理组(TNM组)两组,每组各50例患者。记录两组患者术后白蛋白输注量及输注率,术后电解质紊乱发生率,围手术期白蛋白、电解质浓度变化,总失血量,最大血红蛋白浓度下降值,并发症发生率、术后住院时间及患者满意度。结果:MNM组患者白蛋白输注量及输注率、电解质紊乱发生率均低于TNM组患者(P<0.001或0.05或0.01)。术后第1天MNM组患者血清白蛋白浓度和血清钠、钾、钙离子浓度均高于TNM组患者(P<0.05或0.001)。MNM组患者术后住院时间短于TNM组患者(P<0.001),同时其患者满意度高于TNM组患者(P<0.05)。结论:与传统营养管理模式相比,老年患者TKA围手术期采用多模式营养管理可以明显降低术后营养不良及电解质紊乱发生率,同时缩短患者住院时间,提高患者满意度,值得临床推广。
Background:Malnutrition is a common problem after total knee arthroplasty(TKA),which has attracted much attention from joint surgeons.The malnutrition will increase postoperative complications,prolong hospital stays,and delay recovery.Objective:To compare the impact of multi-modal nutrition management and traditional nutrition management on malnutrition and electrolyte disorder in elderly patients undergoing TKA.Methods:A prospective randomized controlled trial was conducted in 100 elderly patients who underwent unilateral TKA from September 2017 to March 2018.The patients were assigned to multi-modal nutrition management(MNM)group and traditional nutrition management(TNM)group based on random number table(n=50).The amount and rate of postoperative albumin infusion,postoperative electrolyte disorder rate,levels of perioperative albumin and electrolyte,total blood loss,maximum hemoglobin decline,complication rate,postoperative length of stay and patients’satisfaction were recorded.Results:The amount and rate of postoperative albumin infusion and the incidence of electrolyte disorder in the MNM group were significantly lower than those in the TNM group(P<0.001,0.05,0.01).On the day 1 after operation,serum levels of albumin,sodium,potassium and calcium in the MNM group were significantly higher than those in the TNM group(P<0.05,0.001).The postoperative length of stay in the MNM group was significantly shorter than that in the MNM group(P<0.001).Patients’satisfaction in MNM group was significantly higher than that in the TNM(P<0.05).Conclusions:Compared with traditional nutrition management model,multi-mode nutritional management can significantly reduce the incidences of malnutrition and electrolyte imbalance,shorten postoperative length of stay,and improve patients’satisfaction in elderly patients after TKA.
作者
谭毅
黄强
雷国伟
周宗科
裴福兴
TAN Yi;HUANG Qiang;LEI Guowei;ZHOU Zongke;PEI Fuxing(Department of Orthopaedics,Bazhong Hospital of Traditional Chinese Medicine,Bazhong 635500,Sichuan;Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华骨与关节外科杂志》
2021年第3期175-180,共6页
Chinese Journal of Bone and Joint Surgery
基金
国家卫计委2013年度卫生行业科研专项(2013020007)
关键词
全膝关节置换术
多模式营养管理
白蛋白
电解质
Total Knee Arthroplasty
Multi-modal Nutrition Management
Albumin
Electrolyte
作者简介
通信作者:裴福兴,E-mail:fuxingpeihx@gmail.com
