加速康复外科术前术后干预对老年全膝关节置换术后康复效果及生活质量的影响

Effect of preoperative and postoperative intervention of ERAS on rehabilitation effect and quality of life in elderly patients after total knee arthroplasty

目的探讨加速康复外科(ERAS)术前术后干预对老年全膝关节置换术后康复效果和生活质量的影响。方法选择蚌埠医学院第一附属医院2019年7月—2020年12月收治的行全膝关节置换术的老年患者42例作为研究对象,按照随机数字表法分为2组,每组21例,研究组给予ERAS干预,对照组常规治疗,观察2组患者康复效果和生活质量改善情况。结果术后12 h、48 h研究组患者VAS评分[(4.38±1.12)分,(2.71±1.09)分]明显少于对照组[(6.24±1.47)分,(5.87±2.10)分,均P<0.05]。术后2组患者膝关节活动度(ROM)逐渐增加,术后2周、1个月研究组患者ROM[(96.62±7.31)°,(117.83±4.29)°]明显高于对照组[(83.28±6.74)°,(108.27±5.28)°,均P<0.05]。术后2组患者膝关节纽约特种外科医院(HSS)评分逐渐增加,术后1个月、6个月研究组评分[(65.84±7.73)分,(86.74±7.48)分]明显高于对照组[(55.28±6.13)分,(75.33±6.13)分,均P<0.05]。术后2周研究组患者物质生活、躯体功能、心理功能、社会功能和生活质量总评分均明显高于对照组(均P<0.05)。研究组满意度为95.24%,明显高于对照组(61.90%,P<0.05)。结论对全膝关节置换术老年患者实施ERAS干预,能够明显缩短住院时间,降低并发症发生率,有利于关节功能恢复。

Objective To investigate the effect of preoperative and postoperative intervention of enhanced recovery after surgery(ERAS)on rehabilitation effect and quality of life in elderly patients after total knee arthroplasty(TKA).Methods Forty-two elderly patients who underwent TKA in the First Affiliated Hospital of Bengbu Medical College from July 2019 to December 2020 were divided into two groups according to random number table.The study group received intervention of ERAS,and the control group received routine nursing.The rehabilitation effect and quality of life of the two groups were observed.Results The VAS pain scores of the study group[(4.38±1.12)points,(2.71±1.09)points]were significantly lower than those of the control group[(6.24±1.47)points,(5.87±2.10)points]at 12 and 48 hours after operation(all P<0.05).The range of motion(ROM)of the two groups increased gradually after operation,and the ROM of the study group[(96.62±7.31)°,(117.83±4.29)°]were significantly higher than that of the control group[(83.28±6.74)°,(108.27±5.28)°]at 2 weeks and 1 month after operation(all P<0.05).The score of hospital for special surgery knee score(HSS)of patients in the two groups increased gradually after surgery,and the score of the study group[(65.84±7.73)points,(86.74±7.48)points]were significantly higher than that of the control group[(55.28±6.13)points,(75.33±6.13)points]at 1 month and 6 months after surgery(all P<0.05).Two weeks after operation,the total scores of material life,physical function,psychological function,social function and quality of life in the study group were significantly higher than those in the control group(all P<0.05).The satisfaction of the study group was 95.24%,which was significantly higher than that of the control group(61.90%,P<0.05).Conclusion ERAS intervention in elderly patients after TKA can significantly shorten hospitalization time,reduce the incidence of complications,and promote the recovery of knee function.