加速康复外科理念下综合康复评定对膝关节置换术后功能改善的临床研究

Clinical Study on the Effect of Comprehensive Rehabilitation Assessment on the Functional Improvement after Knee Joint Replacement under the Concept of Enhanced Recovery after Surgery

目的:研究加速康复外科(ERAS)理念下综合康复评定对膝关节置换术后功能改善的影响。方法:选取我院2018年5月-2019年12月行膝关节置换术患者62例为研究对象,随机分为常规模式组和ERAS模式组各31例,常规模式组采用传统评定治疗模式,ERAS模式组采用加速康复外科理念下骨科康复科协作模式,比较2组患者在入院时及治疗2周后的数字等级评价量表(NRS)分值膝关节肿胀及功能改善情况,并对比2组并发症的发生比例。结果:2组患者经过2周治疗后,NRS评分显著降低,膝关节肿胀减轻,功能评分显著增高,差异有统计学意义(P<0.05),ERAS模式组患者的评定值与常规模式组对比,差异有统计学意义(P<0.05),ERAS模式组静脉血栓、肌肉萎缩及异常步态的发病率低于常规模式组,差异有统计学意义(P<0.05)。结论:基于加速康复外科理念下的综合康复评定能够指导康复精准介入,在膝关节置换患者疼痛和肿胀减轻、并发症的降低和功能恢复上有明显优势,促进了患者的更好更快的康复,值得应用推广。

Objective:To study the influence of comprehensive rehabilitation assessment under the concept of enhanced recovery after surgery(ERAS)on the functional improvement after knee joint replacement.Methods:A total of 62 patients who underwent knee replacement in our hospital from May 2018 to December 2019 were selected as the research objects,and randomly divided into the conventional model group and the ERAS model group,31 cases of conventional model group was treated with traditional evaluation models,31 cases of ERAS model group adopted the orthopedic rehabilitation technology cooperation model under the concept of enhanced recovery after surgery,the scores of Numerical Rating Scale(NRS),knee swelling and functional improvement were compared between the two groups at admission and two weeks after treatment,and the incidence of complications was compared between the two groups.Results:Two groups of patients after the treatment of two weeks,the NRS score decreased significantly,the knee joint swelling reduced,functional score significantly higher,the difference was statistically significant(P<0.05),ERAS model group of patients with evaluation values compared with conventional model group,the difference was statistically significant(P<0.05),ERAS pattern group had lower incidence of venous thrombosis,muscular atrophy and abnormal gait than the conventional pattern group,the difference was statistically significant(P<0.05).Conclusion:The comprehensive rehabilitation assessment based on the concept of enhanced recovery after surgery can guide the accurate intervention of rehabilitation,and has obvious advantages in the reduction of pain and swelling,reduction of complications and functional recovery of knee replacement patients,and promotes the better and faster rehabilitation of patients,which is worthy of application and promotion.