加速康复外科管理与传统管理在全髋关节置换术中失血量和住院天数的比较

Effect Comparison between Enhanced Recovery after Surgery and Traditional Recovery on Blood Loss in Total Hip Arthroplasty and on Hospitalization Duration

目的探讨加速康复外科(ERAS)管理理念在单侧全髋关节置换术(THA)的围手术期临床应用效果。方法回顾性分析2015年5月至2017年9月127例在复旦大学附属中山医院骨科治疗组接受初次单侧THA的患者资料;其66例应用常规传统管理方案(常规组),61例应用ERAS管理方案(ERAS组),收集2组患者性别、年龄、身高、体重、术前合并症、手术前后Hb和Hct、Hb丢失、Hct丢失、失血量、住院天数,2组间数据比较采用单因素方差分析或2检验。结果χ^2组患者术前一般资料比较差异均无统计学意义,具有可比性。ERAS组总失血量(494.30±289.04)mL低于常规组(910.59±418.81)mL(t=6.47,P<0.001)。ERAS组Hb丢失(16.69±10.66)g/L低于常规组(30.74±15.47)g/L(t=5.92,P<0.001);ERAS组术后住院天数(3.69±1.89)d少于常规组(4.80±1.33)d(t=3.88,P<0.001)。结论ERAS管理模式减少单侧THA围手术期失血量和缩短住院天数。

Objective To discuss the clinical application effect of the management with enhanced recovery after surgery (ERAS) in the perioperative period of unilateral total hip arthroplasty (THA).Methods A retrospective analysis was made to the clinical data of the cases undergoing unilateral THAduring the period fromMay,2015 to Sept.,2017;traditional recovery plan was provided to 66 cases in routine group while ERAS plan to 61 cases in ERAS group;gender,age,body height,body weight,complications before surgery,the levels of hemoglobin (Hb) and hematocrit (Hct) before and after surgery,the loss of Hb and Hct,blood loss and the days of hospitalization in the 2 groups were collected and analyzed by one-way analysis of variance (ANOVA) or 2 test.Results The general information of the cases in the 2 groups before surgery were of no statistical difference;the total blood loss volume in ERAS group was (494.30±289.04) mL,smaller than that in routine group [(910.59±418.81) mL](t=6.47,P<0.001);Hb loss was (16.69±10.66) g/L in ERAS group while that was (30.74±15.47) g/L in routine group,the difference between the 2 groups was of statistical significance (t=5.92,P<0.001);the post-operative time of hospitalization of the cases in ERAS group was (3.69±1.89) days,much shorter than that in routine group [(4.80±1.33) days](t=3.88,P<0.001).Conclusions ERAS management can reduce the blood loss in the perioperative period of unilateral THA and shorten the hospitalization duration.