快速康复外科对创伤性骨折患者术后患肢疼痛及肿胀的影响

The effect of rapid rehabilitation surgery on postoperative pain and swelling of the affected limb in patients with traumatic fracture

目的:探讨快速康复外科(ERAS)对创伤性骨折患者术后患肢疼痛及肿胀的影响。方法:选择2019年9月~2020年9月在我院行手术治疗的创伤性骨折患者100例,依据随机数字表法分为观察组50例与对照组50例。对照组患者采用常规康复理念进行干预,观察组患者采用ERAS理念下的快速康复干预。比较两组患者术前、术后第1天和术后第7天患肢疼痛情况,患肢肿胀、深静脉血栓发生情况和应激指标变化情况,及术前和术后3个月生活质量变化。结果:两组患者术前视觉模拟疼痛评分(VAS)比较无明显差异;两组患者术后第1天和术后第7天VAS评分低于术前;观察组患者术后第1天和术后第7天VAS评分低于对照组。观察组患者患肢肿胀和深静脉血栓发生率低于对照组。两组患者术后第1天和术后第7天血清CRP和Cor水平高于术前;观察组患者术后第1天和术后第7天血清CRP和Cor水平低于对照组。两组患者术后3个月WHOQOL-BREF评分高于术前;观察组患者术后3个月WHOQOL-BREF评分高于对照组。结论:ERAS可减轻创伤性骨折患者术后患肢疼痛,且可降低肿胀发生,改善患者生活质量。

Objective To investigate the effect of rapid rehabilitation surgery (ERAS) on postoperative pain and swelling of the affected limb in patients with traumatic fractures.Methods We selected 100 patients with traumatic fractures in our hospital from September 2019 to September 2020,and divided them into an observation group of 50 cases and a control group of 50 cases according to the random number table method.The patients in the control group adopted the conventional rehabilitation concept,and the patients in the observation group adopted the ERAS concept.The pain,swelling,deep venous thrombosis and stress indexes of the affected limbs at the 1st day after the operation and the 7th day after the operation,as well as the changes of quality of life before and 3 months after operation were compared between the two groups.Results At 1st and 7th postoperative days,,the visual analogue score (VAS) score was lower control group.The observation group incidence of severe limbs and deep vein thrombosis was lower control group.At 1st and 7th postoperative days,serum CRP and Cor levels of patients in the two groups were higher before surgery;the serum CRP and Cor levels of the observation group were lower control group.At 3 months after surgery,the WHOQOL-BREF scores of patients in the 2 groups were higher before surgery;the WHOQOL-BREF scores of patients in the observation group were higher control group.Conclusion ERAS can reduce postoperative pain of the affected limb in patients with traumatic fractures,reduce the occurrence of swelling,and improve the quality of life of patients.