多学科合作管理促进老年髋关节置换术后早期下床活动的效果观察

Effect of multidisciplinary cooperative management on early ambulation after hip arthroplasty in elderly patients

目的探讨多学科合作管理对促进老年髋关节置换术后患者早期下床活动的效果。方法选取2018年1月-2019年8月于浦东医院骨科行髋关节置换手术的患者120例,分为观察组(n=63)和对照组(n=57)。对照组采取常规标准干预;观察组在与对照组相同的基础上,采取由骨科、麻醉科、康复科、营养科和护理多学科协作干预。观察并比较2组首次下床时间、安全事件发生情况和髋关节功能恢复情况。结果实施多学科合作管理干预后,观察组首次下床活动时间明显少于对照组[(2.43±0.78)d vs(4.88±1.10)d,P<0.05]。观察组与对照组治疗不良事件发生率的差异无统计学意义(3.17%vs 7.01%,P>0.05)。护理干预前,2组Harris评分差异无统计学意义(P>0.05);术后7 d和术后15 d,观察组Harris评分均明显高于对照组[(52.27±6.63)分vs(40.65±7.27)分、(68.78±4.82)分vs(58.50±8.65)分,(P<0.05)]。结论多学科协作管理可缩短老年髋关节置换术后患者早期下床活动的时间,改善患肢功能,并未增加安全事件发生,具有一定的临床应用价值。

Objective To explore the effect of multidisciplinary cooperative management on early ambulation after hip arthroplasty in elderly patients.Methods A total of 120 patients who underwent hip arthroplasty in the department of orthopedics of our hospital fromJanuary 2018 toAugust 2019were selected and divided into the control group(n=57)and observation group(n=63).The patients in the control group received routine standard intervention.On the same basis as the control group,the patients in the observation group adopted a multidisciplinary collaborative intervention of orthopedics,anesthesiology,rehabilitation,nutrition and nursing.The time of getting out of bed for the first time,the occurrence of safety events and the recovery of hip joint function were observed and compared between the two groups.Results After the implementation ofmultidisciplinary cooperative management intervention,the time of getting out of bed for the first time of the observation group was shorter than that of the control group[(2.43±0.78)d vs(4.88±1.10)d,P<0.05];the incidence of safety events had no significant difference between the observation group and control group(3.17%vs 7.01%,P>0.05);the Harris scores of the observation group were significantly higher than those of the control group at 7 days and 15 days after the operation[(52.27±6.63)vs(40.65±7.27),(68.78.±4.82)vs(58.50±8.65),(P<0.05)].Conclusion Multidisciplinary collaborative management can shorten the time of getting out of bed in elderly patients after hip arthroplasty,improve the limb function,and does not increase the occurrence of safety events,so it has certain clinical application value.