快速康复外科理念在老年患者全髋关节置换术中的应用效果探讨

The application effect of enhanced recovery after surgery on total hip arthroplasty in elderly patients

目的探讨快速康复外科(ERAS)理念在老年患者全髋关节置换术中的应用效果。方法回顾性分析该院2017-01~2019-01行全髋关节置换术的80例老年患者资料。其中接受ERAS理念指导治疗的40例患者为ERAS组,接受传统治疗方案的40例患者为对照组。比较两组术后髋关节功能Harris评分,术后疼痛视觉模拟评分(VAS)、术后并发症发生率、术后住院时间、住院费用及患者的满意度等情况。结果ERAS组术中平均出血量为(203.88±54.92)ml,对照组为(386.75±131.82)ml,差异有统计学意义(P<0.05)。ERAS组术后并发症发生率为5.00%(2/40),对照组为35.00%(14/40),差异有统计学意义(P<0.05)。ERAS组术后疼痛VAS评分下降趋势较对照组显著(P<0.05),而ERAS组术后髋关节Harris评分上升趋势较对照组显著(P<0.05)。ERAS组术后住院时间短于对照组,住院费用低于对照组,满意率高于对照组,差异有统计学意义(P<0.05)。结论在ERAS理念指导下老年患者行全髋关节置换术后髋关节功能恢复更快、更好,院外指导的完善可降低患者再入院率。

Objective To investigate the application effect of enhanced recovery after surgery(ERAS)on elderly patients undergoing total hip arthroplasty(THA).Methods The data of 80 elderly patients who underwent THA in our hospital from January 2017 to January 2019 were retrospectively analyzed.Among the elderly patients,40 cases receiving ERAS concept-guided treatment as the ERAS group,and the other 40 cases receiving the traditional treatment plan as the control group.The hip joint function Harris scores,Visual Analogue Pain Scale(VAS)scores,postoperative complication rate,postoperative hospital stay,hospitalization costs and the patients′satisfaction rate were compared between the two groups.Results The average intraoperative blood loss was(203.88±54.92)ml in the ERAS group,and(386.75±131.82)ml in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications was 5.00%(2/40)in the ERAS group and 35.00%(14/40)in the control group,and the difference was statistically significant(P<0.05).The postoperative VAS scores in the ERAS group was decreased significantly compared with those in the control group(P<0.05),while the postoperative hip joint Harris scores in the ERAS group was increased significantly compared with those in the control group(P<0.05).The postoperative hospitalization time of the ERAS group was significantly shorter than that of the control group,and the hospitalization costs of the ERAS group were significantly lower than those of the control group.The satisfaction rate of the ERAS group was significantly higher than that of the control group(P<0.05).Conclusion The recovery of hip joint function is faster and better in elderly patients after THA under the guidance of ERAS,and the improvement of out-of-hospital guidance can reduce the re-admission rate of the patients.