快速康复外科在膝关节置换术中的应用及对患者膝关节功能的影响

Application of Rapid Rehabilitation Surgery in Knee Joint Replacement and its Effect on Knee Joint Function

目的观察快速康复外科（fast—track surgery，FTS）在膝关节置换中的应用效果，分析其对患者膝关节功能和生活质量的影响。方法以2015年3月～2016年1月在我院接受膝关节置换术的98例患者为观察对象，年龄50～75岁，并根据随机数字表法将其分为对照组和观察组，每组各49例患者。其中对照组给予传统处理方案，观察组采用FTS理念指导下的围手术期方案。观察两组患者治疗前后膝关节各项体征积分、膝关节功能和生活质量的差别。结果两组患者治疗前膝周压痛、关节活动度等各项体征积分无明显差别，治疗后，两组患者症状积分均较治疗前下降，且观察组低于对照组（P〈0．05）；治疗前两组患者HSS评分、功能和活动度等膝关节功能指标无明显差别，治疗后，两组患者的上述指标均较治疗前升高，且观察组升高更明显（P〈0．05）；两组患者治疗前躯体功能、躯体角色和肢体疼痛等SF-36生活质量评定量表得分无明显差别，治疗后，两组患者的上述指标均较治疗前升高，且观察组升高更明显（P〈0．05）。结论FTS在膝关节置换中有较好的治疗效果，可明显改善患者的膝关节功能和生活质量。

Objective To observe the application effect of FST in knee joint replacement and analyze its influence on the function of the knee joint and the quality of life in the patients wit. Methods 98 patients underwent knee replacement in our hospital from March in 2015 to January in 2016 were enrolled and randomly divided into the control group （n =49） and the intervention group （ n = 49） according to the random number table method. The control group received the traditional treatment program and the intervention group accepted the rapid rehabilitation surgery （FTS）. The knee joint signs points, knee function and quality of life in the two groups before and after treatment were observed. Results There were no significant differences in the signs of tenderness, joint mobility and so on in the two groups before the treatment. After the treatment the symptom scores in the two groups decreased and the scores in the intervention group were lower than those in the control group （ P 〈 0.05 ）. There was no significant difference in HSS score, function and activity between the two groups before treatment. The indexes in the two groups were higher after the treatment than before the treatment. And the ones in the intervention group increased more significantly （ P 〈 0. 05 ） ; There was no significant difference in the physical function, limbs pain and the quality of life in the two groups before treatment. However after the treatment the indexes above in the two groups increased and the ones in the observation group were significantly higher than those in the control group （ P 〈 0. 05 ）. Conclusion FTS has better therapeutic effect in knee joint replacement, which can obviously improve the function of knee joint and the quality of life in the patients.