快速康复理念应用于髋膝关节置换术围术期的效果

Application Effect of Enhanced Recovery after Surgery Concept on Perioperative Period of Hip and Knee Arthroplasty

目的 探讨快速康复理念在髋膝关节置换术围术期的应用效果。方法 选取2018年1月—2020年10月于我院行髋、膝关节置换术的患者80例为研究对象,按照随机数字表法分为观察组与对照组,每组40例。对照组采用常规围术期干预,观察组采用快速康复理念进行围术期干预,比较两组患者的首次排尿时间、离床活动时间、出院时间、术中出血量、术后疼痛程度、生活质量及并发症发生情况。结果 观察组患者的首次排尿时间、离床活动时间、出院时间均短于对照组,术中出血量少于对照组,组间差异有统计学意义(P<0.05)。观察组患者术后24 h的疼痛视觉模拟评分明显低于对照组,差异有统计学意义(P<0.05)。观察组患者术后1个月的各项生活质量综合评定问卷评分明显高于对照组,组间差异有统计学意义(P<0.05)。观察组的并发症发生率为2.50%,明显低于对照组的15.00%,差异有统计学意义(P<0.05)。结论 将快速康复理念应用于髋、膝关节置换术围术期,可促进患者康复,减少术中出血,缓解术后疼痛,降低并发症发生率,效果显著,值得临床推广。

Objective To investigate the effect of enhanced recovery after surgery concept in perioperative period of hip and knee replacement.Methods 80 patients who underwent hip and knee replacement in our hospital from January 2018 to October 2020 were selected as the research objects,and were divided into an observation group and a control group according to random number table method,with 40 patients in each group.The control group was given routine perioperative intervention,the observation group was given perioperative intervention based on the concept of enhanced recover after surgery.The time of first urination,time to get out of bed,time to discharge,intraoperative blood loss,postoperative pain,quality of life and the occurrence of complications were compared between the two groups.Results The time of first urination,time of getting out of bed and time of discharge in the observation group were shorter than those in the control group,and the amount of intraoperative blood loss was less than that in the control group,the differences between the groups were statistically significant(P<0.05).The 24 h postoperative pain visual analogue scale score in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The scores of generic quality of life inventory-74 in the observation group 1 month after surgery were significantly higher than those in the control group,the differences between the groups were statistically significant(P<0.05).The complication rate of the observation group was 2.50%,which was significantly lower than 15.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of the concept of rapid rehabilitation in the perioperative period of hip and knee replacement can promote the rehabilitation of patients,reduce intraoperative bleeding,relieve postoperative pain,and reduce the incidence of complications.The effect is significant and worthy of clinical promotion.