快速康复流程模式下全膝关节置换术后延迟出院原因分析

Reasons for Delayed Discharge after Total Knee Arthroplasty under Fast-track Recovery Model

目的了解在快速康复流程(FT)模式下全膝关节置换术(TKA)患者延迟出院的现状,探讨其原因。方法回顾性分析2014年1月-10月收治的采用FT模式进行围手术期管理的患者152例,并记录术后72 h未出院的情况,分析其延迟出院的原因。结果 152例患者中,119例患者术后72 h未出院,延迟出院率为78.2%。疼痛(32.8%)、膝关节活动度不达标(31.9%)及患者不愿意出院(27.7%)是延迟出院的主要原因。结论通过FT模式在TKA中的应用可缩短住院时间,节约患者住院费用,加快患者术后康复,但要达到国外术后72 h出院标准仍有很大提升空间。

Objective To illustrate the situation of delayed discharge of patients at er total knee arthroplasty（TKA） under fast-track（FT） recovery model,and analyze the reasons.Methods We retrospectively analyzed the clinical data of 152 patients who accepted perioperative management under fast-track model from January to December 2014.The reasons for discharging over 72 hours at er hospitalization were analyzed.Results Among the 152 patients,119 were discharged over 72 hours at er surgery,and the rate was 78.2%.The main reasons for delayed discharge were pain（32.8%）,limited range of motion（31.9%） and unwillingness to be discharged（27.7%）,respectively.Conclusion For patients who have undergone TKA,FT model can shorten hospital stay,save expenses,and accelerate postoperative rehabilitation,but there is still much room for improvement.