快速康复外科理念于军事训练伤致急性髌骨脱位围术期中应用价值

The value of the concept of enhanced recowery after surgery in the perioperative period of acute patellar dislocation caused by military training

目的探讨快速康复外科(ERAS)理念于军事训练伤致急性髌骨脱位围术期中的应用价值。方法选取北部战区总医院自2013年1月至2018年12月收治的54例急性髌骨脱位官兵为研究对象。根据不同的干预措施将其分为传统康复组(n=26)与快速康复组(n=28)。比较两组官兵术后1、24、48、72 h的疼痛视觉模拟(VAS)评分,术后1、3、6个月的膝关节功能(Lysholm)评分、国际膝关节文献委员会(IKDC)评分。分析并比较两组官兵术后并发症发生情况、住院时间、下地时间及术中出血量。结果快速康复组官兵术后1、24、48、72 h的VAS评分均明显低于传统康复组,差异均有统计学意义(P<0.05);快速康复组术后1、3、6个月的Lysholm评分及术后1、3、6个月的IKDC评分均明显优于传统康复组,差异均有统计学意义(P<0.05);快速康复组下地时间、出血量及住院时间均明显优于传统康复组,差异有统计学意义(P<0.05)。结论军事训练伤致急性髌骨脱位术围术期中采用ERAS理念临床效果显著,可明显减轻疼痛,改善预后。

Objective To investigate the value of the concept of enhanced recowery after surgery(ERAS)in perioperative period of acute patellar dislocation caused by military training.Methods A retrospective study was performed on 54 cases of military patients with acute patellar dislocation who were admitted from January 2013 to December 2018.Patients were divided into the traditional rehabilitation group(n=26)and the rapid rehabilitation group(n=28)according to different interventions.Visual analogue pain scale(VAS)of soldiers in the two groups at 1,24,48 and 72 hours after surgery,Lysholm scores and international knee documentation commitee knee(IKDC)scores at 1,3 and 6 months after surgery were compared.The incidence of postoperative complications,length of stay in hospital,time on the ground and intraoperative blood loss in the two groups were analyzed and compared.Results VAS scores of soldiers in the rapid rehabilitation group at 1,24,48 and 72 hours after surgery were significantly lower than those in the traditional rehabilitation group,with statistically significant differences(P<0.05).Lysholm score and IKDC score of the rapid rehabilitation group at 1,3 and 6 months after surgery were significantly better than that of the traditional rehabilitation group(P<0.05).The ground time,blood loss and hospital stay in the rapid rehabilitation group were significantly better than those in the traditional rehabilitation group(P<0.05).Conclusion ERAS is in perioperative period of acute patellar dislocation caused by military training injury and has significant application value.