基于快速康复外科理念的临床护理路径在膝关节创伤性滑膜炎围手术期中的应用研究

Application of Perioperative Clinical Nursing Path Based on Fast Track Surgery Concept for Traumatic Synovitis of Knee Joint

目的:探讨基于快速康复外科(FST)理念的临床护理路径(CNP)在膝关节创伤性滑膜炎围手术期中的应用效果。方法:对笔者所在医院2018年12月-2020年7月治疗的70例行全膝关节置换(TKA)治疗的膝关节创伤性滑膜炎患者临床资料进行回顾性分析,将2018年12月-2019年8月治疗的35例患者纳入对照组,2019年9月-2020年7月治疗的35例患者纳入观察组。对照组给予常规护理,观察组在对照组基础上给予快速康复外科理念的临床护理路径。比较两组住院情况、护理满意度、并发症发生情况及各时间段HSS膝关节评分、Barthel指数、SF-36评分水平。结果:术后7、30、90 d,两组HSS膝关节评分、Barthel指数评分、SF-36评分均高于术前,且观察组各项评分均高于对照组,差异均有统计学意义(P<0.05);观察组平均住院费用少于对照组,下床活动时间早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05);观察组护理总满意度(97.14%)高于对照组(77.14%),并发症总发生率(5.72%)低于对照组(22.88%),差异均有统计学意义(P<0.05)。结论:在膝关节创伤性滑膜炎围手术期中应用FST理念的CNP护理可有效改善患者膝关节功能,提高生活质量及护理满意度,且可节约医疗经费,降低围术期并发症。

Objective:To investigate the application effect of perioperative clinical nursing path (CNP) based on fast track surgery (FST) concept for traumatic synovitis of knee joint.Method:The clinical data of 70 patients with traumatic synovitis of knee joint with TKA treatment from December 2018 to July 2020 in our hospital were retrospectively analyzed,and 35 patients from December 2018 to August 2019 were included into the control group,and 35 patients from September 2019 to July 2020 were included into the observation group.The control group received the routine nursing,based on this,the observation group received the CNP based on FST concept.Then the hospitalization,nursing satisfaction,complications,HSS knee score,Barthel index,and SF-36 score were compared between the two groups.Result:At 7,30 and 90 days after surgery,HSS knee score,Barthel index score and SF-36 score in both groups were higher than those before surgery,and scores in the observation group were higher than those in the control group,the differences were statistically significant (P<0.05).The average hospitalization cost in the observation group was less than that in the control group,the time of getting out of bed was earlier than that in the control group,and the length of hospitalization was shorter than that in the control group,the differences were statistically significant (P<0.05).The total nursing satisfaction in the observation group (97.14%) was higher than that in the control group (77.14%),and the total incidence of complications (5.72%) was lower than that in the control group (22.88%),the differences were statistically significant (P<0.05).Conclusion:The application of CNP based on FST concept for patients with traumatic synovitis of knee joint has various advantages,including the amelioration of the knee function,quality of life,nursing satisfaction,less medical expenses and perioperative complications.