基于加速康复外科理念的个案管理应用于人工髋关节置换术患者的效果

Effect of Case Management Based on the Concept of Enhanced Recovery after Surgery in Patients with Artificial Hip Replacement

目的探讨基于加速康复外科理念(ERAS)的个案管理应用于人工髋关节置换术患者的效果。方法选取2018年1月-2022年2月于我院行人工髋关节置换术的60例患者,按照随机数字表法分将其为对照组和观察组,每组各30例。对照组实施基于ERAS的护理,观察组实施基于ERAS的个案管理护理。对比两组的围术期指标、髋关节功能及疼痛情况。结果观察组的首次下床活动及住院时间短于对照组,住院花费低于对照组(P<0.05)。两组各时间点的Harris评分对比差异均无统计学意义(P>0.05);观察组术后48 h、出院时的数字评分法(NRS)低于对照组(P<0.05)。结论人工髋关节置换术患者实施基于ERAS的个案管理护理有助于减轻患者术后疼痛,可以加快其下床活动及术后康复出院,并减少费用,但在短期内其髋关节功能恢复的效果不明显。

Objective:To investigate the effect of case management based on the concept of enhanced recovery after surgery(ERAS)in patients with artificial hip replacement.Methods:A total of 60 patients who underwent artificial hip replacement in our hospital from January 2018 to February 2022 were included and divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group implemented ERAS-based nursing,and the observation group implemented ERAS-based case management nursing.The perioperative indicators,hip function and pain were compared between the two groups.Results:The first out-of-bed activity and hospital stay in the observation group were shorter than those in the control group,and the hospitalization expenses were lower than those in the control group(P<0.05).There was no significant difference in Harris score between the two groups at each time point(P>0.05);The numerical scale(NRS)of the observation group at48 h after operation and at discharge was lower than that of the control group(P<0.05).Conclusion:ERAS-based case management nursing for patients undergoing artificial hip replacement can help alleviate postoperative pain,accelerate patients’mobility and postoperative rehabilitation and discharge,and reduce costs,but the effect of functional recovery of hip arthroplasty is not obvious in the short term.