快速康复外科理念在膝关节置换术围手术期护理中的效果

Effect of Fast Track Surgery in Perioperative Nursing Care of Patients Undergoing Total Knee Arthroplasty

目的分析膝关节置换术围手术期护理中快速康复外科理念的应用效果。方法选取2019年1月—2020年12月在医院行膝关节置换术的患者94例,采用随机数字表法分为两组,各47例。对照组采用常规围手术期护理,研究组在快速康复外科理念指导下,开展围手术期护理,比较两组术后恢复情况、实验室指标、VAS评分、膝关节功能及膝关节活动度等情况。结果研究组术后首次排尿时间、首次排便时间、下床活动时间及住院时间短于对照组,差异有统计学意义(P<0.05)。研究组术后CRP水平低于对照组,差异有统计学意义(P<0.05),两组术后血沉水平比较,差异无统计学意义(P>0.05)。研究组术后VAS评分(1.57±0.34)分,低于对照组的(1.98±0.46)分,膝关节活动度(105.48±6.53)°,高于对照组的(96.82±6.17)°,组间差异有统计学意义(P<0.05)。研究组术后膝关节功能优良率高于对照组,并发症发生率低于对照组,对比差异有统计学意义(P<0.05)。结论在膝关节置换术患者中,采用基于快速康复外科理念的围手术期护理干预,可有效减轻患者术后疼痛,缩短术后康复时间,促进患者膝关节功能改善。

Objective To analyze the application effect of fast track surgery concept in perioperative nursing of knee arthroplasty.Methods 94 patients with knee arthroplasty in our hospital from January 2019 to December 2020 were selected and randomly divided into two groups by random number table,47 cases in each group.The control group was given routine perioperative nursing,while the study group was given perioperative nursing under the guidance of fast track surgery.The postoperative recovery status,laboratory indexes,VAS score,knee function and range of motion of the two groups were compared.Results The first urination time,first defecation time,ambulation time and hospitalization time after surgery of the study group were shorter than those of the control group,with statistical difference(P<0.05).The level of CRP in the study group was lower than that in the control group(P<0.05).There was no significant difference in the level of erythrocyte sedimentation rate between the two groups(P>0.05).The postoperative VAS score of the study group was(1.57±0.34)points,which was lower than(1.98±0.46)points of the control group,and the range of motion of the knee joint was(105.48±6.53)°,which was higher than(96.82±6.17)°of the control group,with significant difference between the two groups(P<0.05).After operation,the excellent and good rate of knee joint function in the study group was higher than that in the control group,and the incidence of complications was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion In the perioperative nursing of patients with knee arthroplasty,the nursing intervention based on the concept of rapid rehabilitation surgery can effectively reduce the postoperative pain,shorten the postoperative recovery time,and promote the improvement of knee joint function.