快速康复外科理念在全膝关节置换患者护理中的应用

Clinical application of enhanced recovery after surgery for patients with total knee arthroplasty

目的 采用快速康复护理流程对全膝关节置换围手术期患者进行护理,探讨对患者术后安全、康复时间及住院满意度的影响.方法 检索国内外发表的相关文献,筛选出临床随机对照研究的证据,对快速康复护理流程根据当前文献证据进行选择性优化,制订出更有利于患者康复及提高患者满意度的快速康复护理程序.并于2015年1月-2017年1月期间对58例行全膝关节置换术的患者实施快速康复护理程序.观察患者出院时间、术后满意度及出院时关节活动度等指标.结果 患者住院时间为2~6(2.73±1.14)d,满意度评价为7~10(9.68±0.32)分,关节活动度为84.87°±22.62°.无切口感染、肺炎、血栓等并发症的发生,患者无再次手术(包括和置换膝关节相关的手术)、再入院情况发生.结论 应用快速康复外科理念优化全膝关节置换术围手术期护理方案,可缩短患者住院时间,降低并发症的发生率,使患者快速恢复到可以日常活动,提高护理满意度.

Objective To explore the effects of enhanced recovery care on safety,recovery time and satisfaction of patients after unilateral total knee arthroplasty (TKA). Methods By reviewing relevant literature published, we referred to the evidence from clinical randomized controlled trials, and optimized the accelerated rehabilitation process based on current literature evidence. The enhanced recovery program was developed. Fifty-eight patients who received unilateral total knee arthroplasty from January 2015 to January 2017 were cared of according to the developed enhanced recovery program. Patients5 length of stay in hospital, satisfaction score, and range of motion at the time of discharge was recorded. Results The length of stay in hospital was 2 to 6 days, with an average of 2.73± 1.14 days. Patients* satisfaction score was 7 ?10 points, with an average of 9.68 ±0.32 points. The range of motion was 84.87°±22.62°. There was no complications such as infection, pneumonia,thrombosis,reoperation and re-admission. Conclusion The application of enhanced rehabilitation care can shorten the length of stay in hospital, reduce the incidence of complications, enable patients quickly recover to daily activities, and improve patient satisfaction level.