强直髋全髋置换术的医疗团队资源管理

Team resource management used in total hip arthroplasty for ankylosed hip secondary to ankylosis spondylitis

[目的]探讨医疗团队资源管理(team resource management,TRM)在强直性脊柱炎(ankylosing spondylitis,AS)强直髋全髋关节置换术(total hip arthroplasty,THA)中的应用效果。[方法]回顾性分析本院关节外科2018年8月—2021年9月收治的37例(45髋)AS强直髋行THA患者的临床资料。依据医患沟通结果,20例(23髋)住院期间给予TRM干预(TRM组);17例(22髋)住院期间给予常规医疗护理干预(常规组)。比较两组住院期间临床与血检验资料。[结果]两组患者均顺利完成手术,术中均无严重并发症。TRM组麻醉时间显著优于常规组(P<0.05)。TRM组手术时间、下地行走时间以及住院时间优于常规组,但差异无统计学意义(P>0.05)。常规组切口长度显著短于TRM组(P<0.05),术中失血量显著少于TRM组(P<0.05)。两组患者切口愈合等级的差异无统计学意义(P>0.05)。术后3 d,TRM组Hb、Hct均优于常规组(P<0.05),而两组间CRP及ESR的差异无统计学意义(P>0.05)[结论]AS强直髋患者住院期间接受TRM可以提升术前准备的工作效率,并提升患者满意度。

[Objective]To evaluate the outcomes during hospitalization of team resource management(TRM)used in total hip arthroplasty(THA)for ankylosed hip secondary to ankylosing spondylitis(AS).[Methods]A retrospective study was done on 37 patients(45hips)who underwent THA for ankylosed hip after AS in our hospital from August 2018 to September 2021.According to doctor-patient communication,20 patients(25 hips)received TRM intervention during hospitalization(TRM group),while the remaining 17 patients(22hips)received routine medical care intervention(routine group).The clinical and blood test data during hospitalization were compared between the two groups.[Results]All patients in both groups were successfully operated on without serious complications.The TRM group proved significantly superior to the routine group in terms of intra-operative anesthesia time and VAS score at 7 days postoperatively(P<0.05).Regarding to blood test,the TRM group was better than the routine group in Hb and Hct(P<0.05).[Conclusion]The TRM does improve preoperative preparation efficiency with considerably improved satisfaction of patient with ankylosed hip after AS.