加速康复理念在微创髋关节置换围手术期护理中的应用

Application of fast-track rehabilitation concept in perioperative nursing of minimally invasive hip replacement

目的评价加速康复外科理念指导下微创髋关节置换患者围手术期康复治疗的效果。方法选取我院收治的股骨头无菌性坏死及股骨颈骨折患者72例,按入院时间分成FTS护理组和传统护理组,每组36例。传统护理组患者实施传统的临床路径,FTS组患者实施应用FTS贯穿于人工髋关节置换术临床路径中进行治疗及护理优化,对两组患者的护理及治疗效果进行回顾性分析。结果 FTS组护理满意度优于传统护理组(P<0.05),FTS组住院天数及住院费用均低于传统组(P<0.05),两组术后远期康复效果第3个月及第6个月ADL评分无明显差异(t=-1.467、P=0.147;t=-1.599、P=0.114),但在近期康复效果术后2周及1个月ADL评分可看出,FTS组患者ADL分值高于传统护理组,差异有统计学意义(t=-2.307、P=0.024;t=-2.451、P=0.017)。结论在人工髋关节置换术临床路径中,应用加速康复理念能有效防止并发症的发生,缩短住院天数及减少住院费用,提高护理满意度,加快人工髋关节置换术患者功能恢复,提高生活质量。

Objective To evaluate the perioperative rehabilitation treatment effects of the patients receiving minimally invasive hip replacement under the guidance of fast-track rehabilitation surgery concept. Methods Seventy-two patients with femoral head aseptic necrosis and femoral neck fractures treated in our hospital were selected and divided into the FTS nursing group and the traditional nursing group according to the hospital admission time, with 36 patients in each group. The traditional nursing group followed the traditional clinical pathway and the FTS group followed the clinical pathway with FTS run through artificial hip replacement for the purpose of treatment and optimized nursing.The nursing and treatment effects of the two groups were analyzed retrospectively. Results The FTS group had better nursing satisfaction than the traditional nursing group（P〈0.05）, and shorter hospital stay and lower hospitalization cost than the traditional group（P〈0.05）. In terms of postoperative long-term rehabilitation effect, the two groups were not significantly different in the ADL scores in the 3rd and 6th month（t=-1.467, P=0.147; t=-1.599, P=0.114）, but in terms of postoperative short-term rehabilitation effect, the FTS group had higher ADL scores than the traditional nursing group in the 2nd week and 1st month, with statistically significant differences（t=-2.307, P=0.024; t=-2.451, P=0.017）.Conclusion In the clinical pathway of artificial hip replacement, the application of fast-track rehabilitation concept can effectively prevent the occurrence of complications, shorten hospital stay, reduce hospitalization cost, improve nursing satisfaction, accelerate functional recovery of the patients receiving artificial hip replacement and improve the quality of life.