快速康复外科理念在关节镜下肩关节复发性前脱位修复术中应用研究

Application of the concept of enhanced recovery after surgery in the repair of recurrent anterior dislocation of shoulder joint under arthroscopy

目的探讨快速康复外科理念在关节镜下肩关节复发性前脱位修复术中的应用效果。方法选取自2012年1月至2018年1月确诊为复发性肩关节前脱位的244例患者为研究对象,其中,采用快速康复外科理念治疗的122例患者为快速康复组,采用常规治疗的122例患者为传统康复组。比较两组患者术后住院时间、活动时间、并发症、加州大学肩关节评分(UCLA)及术后患肩视觉疼痛模拟评分(VAS)。结果两组患者的住院时间、并发症发生率比较,差异无统计学意义(P>0.05)。术后48、72 h,快速康复组的VAS评分均显著低于传统康复组,差异有统计学意义(P<0.05)。两组术后UCLA评分均较术前明显升高,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。结论关节镜下肩关节复发性前脱位修复术围术期应用快速康复理念安全、有效,可有效减轻患者疼痛,促进肩关节恢复。

Objective To investigate the effect of rapid rehabilitation in the treatment of recurrent anterior dislocation of shoulder joint under arthroscopy.Methods The 122 patients diagnosed with recurrent anterior dislocation of shoulder joint and treated with enhanced recovery after surgery from January 2012 to January 2018 were selected as the rapid recovery group.The other 122 patients with conventional treatment were selected as the traditional rehabilitation group.The length of hospital stay,time of movement,complications,University of California at Los Angeles(UCLA)shoulder score and visual analogue scale(VAS)were compared between the two groups.Results There was no significant difference between the two groups in length of stay and incidence of complications(P>0.05).VAS scores of the rapid recovery group were significantly lower than those of the traditional recovery group at 48 and 72 hours after the operation(P<0.05).The postoperative UCLA scores of the two groups were significantly higher than those of the two groups before operation(P<0.05).There was no significant difference in UCLA scores between the two groups(P>0.05).Conclusion It is safe and effective to apply the concept of enhanced recovery after surgery in the perioperative period for the repair of recurrent anterior dislocation of shoulder joint under arthroscope,which can effectively reduce the pain of patients and promote the recovery of shoulder joint.