加速康复外科理念在老年全髋关节置换术围术期的临床应用研究

Clinical Application of Enhanced Recovery after Surgery Concept in Perioperative Period of Total Hip Arthroplasty in Elderly Patients

目的研究加速康复外科理念在老年人全髋关节置换围术期的临床应用效果。方法回顾性分析宁夏医科大学总医院2017年1月至2019年1月因髋关节病变行人工全髋关节置换术治疗的100例老年患者,按照随机双盲法分为研究组(n=50)和对照组(n=50),研究组围术期在常规护理基础上应用加速康复外科理念,对照组围术期采用常规护理理念,所有患者资料均获得完整随访;观察两组患者手术时间、术中出血量、住院时间、切口愈合时间、术后并发症、患髋髋关节功能评分(Harris)及视觉模拟评分(VAS)。结果研究组患者术中出血量、住院时间、切口愈合时间、术后并发症均少于对照组(P均<0.05);术后1、3个月研究组患者患髋Harris评分高于对照组,VAS评分低于对照组(P均<0.05)。结论加速康复外科理念在老年人全髋关节置换围术期的近期临床效果优于常规护理,可减少术中出血量、缩短住院时间及降低术后并发症,并促进髋关节功能恢复。

Objective To study the clinical effect of the concept of enhanced recovery after surgery in the perioperative period of total hip arthroplasty in the elderly.Methods A retrospective analysis was made on100 elderly patients who underwent total hip arthroplasty for hip joint diseases in our hospital from January2017 to January 2019.According to the randomized double-blind method,the study group was divided into study group(n=50)and the control group(n=50).The study group applied the concept of accelerated rehabilitation surgery on the basis of routine nursing during the perioperative period,while the control group adopted the concept of routine nursing during the perioperative period.All patients were followed up completely.The operation time,intraoperative bleeding volume,hospitalization time,postoperative complications,Harris score and VAS score were observed.Results The intraoperative blood loss,hospitalization time,incision healing time and postoperative complications of the study group were less than those of the control group(P all<0.05).Harris scores of hip 1 and 3 months after operation in the study group were higher than those of the control group,and VAS score was lower than that of the control group(P all<0.05).Conclusion The clinical effect of the concept of accelerated rehabilitation surgery is better than that of routine nursing in the perioperative period of total hip arthroplasty in the elderly.It can reduce the amount of bleeding during the operation,shorten the length of hospital stay,reduce the postoperative complications,and promote the recovery of hip joint function.