ERAS理念在膝骨关节炎患者行TKA围手术期护理中的应用

Application of ERAS Concept in Perioperative Nursing of Patients with Knee Osteoarthritis undergoing TKA

目的:研究及分析院前基于加速康复外科(ERAS)理念在促进膝骨关节炎患者行人工全膝关节置换术(TKA)术后康复的效果。方法:选取2019年6-12月本院骨科31例行人工全膝关节置换术的患者为对照组,选取2020年1-7月本院骨科31例行人工全膝关节置换术的患者为观察组。对照组实施常规护理,观察组采用ERAS理念护理。比较两组住院当天、术后1、3、5 d的VAS评分和HSS评分;比较两组住院天数和患者就医过程满意度。结果:住院当天,两组VAS、HSS评分比较,差异均无统计学意义(P>0.05);术后1、3、5 d,观察组VAS评分均低于对照组,HSS评分均高于对照组,差异均有统计学意义(P<0.05)。观察组住院天数短于对照组,观察组患者就医过程满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论:基于加速康复外科理念采取的干预措施可为患者手术创造良好的生理、心理条件,缩短了患者术后康复时间,完善和丰富了加速康复外科的护理内涵,具有较好的临床引用前景。

Objective:To study and analyze the effect of pre-hospital based on the concept of enhanced recovery after surgery (ERAS) on promoting the rehabilitation of patients with knee osteoarthritis after total knee arthroplasty (TKA).Method:A total of 32 patients who underwent total knee arthroplasty in the department of orthopedics of our hospital from June to December 2019 were selected as the control group,and 31 patients who underwent total knee arthroplasty in the department of orthopedics of our hospital from January to July 2020 were selected as the observation group.The control group received routine nursing,and the observation group received ERAS concept nursing.VAS scores and HSS scores were compared between two groups on the day of hospitalization and 1,3 and 5 d after surgery;the length of stay and the satisfaction of patients’ medical treatment process were compared between two groups.Result:On the day of hospitalization,there were no significant differences in VAS scores and HSS scores between two groups (P>0.05);1,3 and 5 d after surgery,VAS scores in the observation group were lower than those in the control group,HSS scores in observation group were higher than those in control group,the differences were statistically significant (P<0.05).The days of hospitalization in the observation group was shorter than that in the control group,and the satisfaction score of medical treatment process in the observation group was higher than that in the control group,the differences were statistically significant (P<0.05).Conclusion:The intervention measures based on the concept of enhanced recovery after surgery can create good physical and psychological conditions for patients undergoing surgery,shorten the postoperative rehabilitation time of patients,improve and enrich the nursing connotation of enhanced recovery after surgery,with a good prospect of clinical citation.