摘要
目的研究快速康复外科理念在人工膝关节手术中的应用。方法行人工膝关节置换手术的患者60例,随机分为快速康复外科理念围术期组(观察组)和传统方法围术期组(对照组),每组30例,观察组行快速康复外科理念指导下的围术期管理,对照组按传统方法进行围术期管理,对两组术前、术后膝关节活动度,膝关节功能评分(KSS),术后疼痛视觉模拟评分(VAS),住院时间,术中及术后出血量,并发症发生情况及患者满意度等多项指标进行统计学分析。结果术前、术后膝关节活动度,住院时间,术中及术后出血量,并发症发生情况及患者满意度明显低于对照组(P<0.05);术后1个月内的VAS评分,快速康复组明显优于传统方法组(P<0.05);术后3个月、6个月的VAS评分,两组间无统计学差别(P>0.05);术后1个月及3个月的KSS评分快速康复组明显优于传统方法组(P<0.05);术后6个月的KSS评分,两组间无统计学差异(P>0.05)。结论应用快速康复外科理论,可以最大限度地降低术后切口周围的软组织肿胀、疼痛程度,可以确保患者更早地下床活动(术后4 h),更好地恢复关节功能,更少地产生术后并发症,从而达到医患均满意的治疗效果。
Objective To study the application of ERAS(Enhanced Recovery After Surgery,ERAS)concept in artificial joint surgery.Methods 60 patients underwent artificial knee replacement surgery in joint surgery department were randomly divided into observation group and control group(n=30).The observation group received perioperative management under the guidance of the concept of rapid rehabilitation surgery,while the control group received perioperative management according to traditional methods.The preoperative and postoperative knee joint activity,knee joint function score(KSS),postoperative pain visual analog score(VAS),hospitalization time,intraoperative and postoperative bleeding,complications and patient satisfaction were analyzed between two groups.Results The knee joint activity,hospitalization time,intraoperative and postoperative bleeding,complications and patient satisfaction in the observation group were significantly lower than those in the control group(P<0.05).The VAS scores within one month after operation was significantly better in the rapid rehabilitation group than those in the traditional method group(P<0.05).The VAS scores at three months and 6 months after operation showed no statistical difference between the two groups(P>0.05).The KSS scores at one month and three months after operation in the rapid rehabilitation group was significantly better than those in the traditional method group(P<0.05).There was no statistical difference in KSS scores between the two groups 6 months after operation(P<0.05).Conclusion The application of ERAS can reduce the swelling and pain,ensure the patients to get out of bed earlier(four hours after surgery),better joint function and fewer postoperative complications,thus achieving a satisfactory therapeutic effect for both doctors and patients.
作者
宋强
高原
刘泽欣
张强
李聪
孙玺淳
马军
牛东生
刘小凡
白志刚
SONG Qiang;GAO Yuan;LIU Zexin;ZHANG Qiang;LI Cong;SUN Xichun;MA Jun;NIU Dongsheng;LIU Xiaofan;BAI Zhigang(Department of Orthopedics,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Medical School of Northwest University for Nationalities,Lanzhou 730030,China)
出处
《宁夏医学杂志》
CAS
2020年第9期780-783,共4页
Ningxia Medical Journal
基金
西北民族大学2019年中央高校基本科研业务项目(31920190188)
宁夏科技厅重点研发项目(2018BFH03022)
关键词
人工膝关节置换术
快速康复外科理念
KSS评分
Artificial knee replacement
Enhanced recovery after surgery
Knee joint function score
作者简介
宋强(1984-),男,主治医师,硕士研究生,研究方向为关节外科;通讯作者:白志刚,Email:bzg19730526@qq.com
