快速康复理念下早期下床活动对单侧全膝关节置换患者术后并发症的影响

Effect of Early Ambulation in Patients on Complications after Total Knee Arthroplasty,Based on the Concept of Fast Track Surgery

目的探讨快速康复理念下早期下床活动对全膝关节置换患者术后并发症的影响。方法选取100例行单侧全膝关节置换的患者,按入院时间分为观察组(53例)和对照组(47例)。观察组应用快速康复外科围手术期护理理念,术后6h开始医护共同评估病情并实施早期下床活动;对照组采取常规围手术期护理方案,术后第1~3天下床活动。两组患者均由固定医生与专科康复护士进行资料收集。比较两组患者术后肺部感染、深静脉血栓形成、伤口愈合不良等并发症的发生率。结果观察组患者术后伤口愈合不良发生率与对照组无明显差异(P>0.05);观察组术后肺部感染、深静脉血栓形成等并发症的发生率明显低于对照组(P<0.01)。结论快速康复理念下医护合作实施全膝关节置换患者早期下床活动可以降低并发症的发生率,提高护理质量,有较高的临床推广应用价值。

Objective To investigate the effect of early ambulation in patients on complications(TKA).Methods 100 patients who underwent unilateral total knee arthroplasty were divided into observation group(n=53)and control group(n=47)according to admission time.The patients in observation group received the nursing which was combined with rapid recovery concept in the perioperative period.They were required to ambulate in 6 hours after surgery with doctor-nurse collaboration.The patients in control group received routine nursing and were required to ambulate in 1-3 days after surgery.The rate of lung infection,deep-vein thrombosis and poor wound healing were compared between two groups.Results There was no significant difference in the incidence of postoperative wound healing between the observation group and the control group(P>0.05).The incidence of postoperative pulmonary infection and deep vein thrombosis was significantly lower in the observation group than in the control group(P<0.01).Conclusion Under the concept of fast track surgery,doctor-nurse cooperation and early ambulation in patients after total knee arthroplasty can reduce the incidence of complications and improve the postoperative knee joint function of patients,which is of high clinical application value.