加速康复外科管理措施提高老年肩峰下撞击综合征病人肩关节镜下肩峰成形术后效果

Effects of enhanced recovery after surgery on the efficacy of arthroscopic acromioplasty in elderly patients with subacromial impingement syndrome

目的分析加速康复外科(ERAS)管理措施对老年肩峰下撞击综合征(SAIS)病人肩关节镜下肩峰成形术疗效的影响。方法回顾性收集2017年7月至2021年11月在我院接受肩关节镜下肩峰成形术治疗的38例老年SAIS病人的资料,按围手术期管理方式分为传统组(18例)与ERAS组(20例)。记录并比较2组术前、出院时及出院后1、2、3个月时改良版美国加州大学肩关节评分(UCLA评分)与VAS评分,术后住院时间及并发症发生率。结果2组术后UCLA及VAS评分均较术前改善,ERAS组出院时、出院后1个月时UCLA评分均高于传统组,出院后1个月时VAS评分低于传统组,差异均有统计学意义(P<0.05或P<0.01)。ERAS组术后住院时间短于传统组,差异有统计学意义(P<0.05),但2组间并发症发生率差异无统计学意义(P>0.05)。结论ERAS管理措施应用于老年SAIS病人肩关节镜下肩峰成形术可减轻术后疼痛、促进关节功能康复、缩短住院时间,加速病人的术后恢复。

Objective To analyze the effects of enhanced recovery after surgery(ERAS)measures in the elderly patients with subacromial impingement syndrome(SAIS)undergoing arthroscopic acromioplasty.Methods The clinical data of 38 elderly patients with SAIS receiving arthroscopic acromioplasty in our hospital from July 2017 to November 2021 was retrospectively collected.All the patients were divided into the traditional group(18 cases)and the ERAS group(20 cases)according to different perioperative management.The scores of the modified UCLA Shoulder Rating Scale(UCLA scale)and visual analogue scale(VAS)before operation,at discharge,1,2,3 months after discharge and the postoperative hospital stay,and the incidence of complications were observed and compared between the two groups.Results The scores of UCLA scale and VAS were significantly improved in both groups after operation.The UCLA score in the ERAS group at discharge and 1 month after discharge was significantly higher than that in the traditional group,and the VAS score in the ERAS group was lower than that in the traditional group 1 month after discharge(P<0.05 or P<0.01).There was significant difference in hospital stay between the two groups(P<0.05),while the incidence rate of complications showed no statistical difference.Conclusion ERAS management may relieve the pain,accelerate shoulder rehabilitation and shorten the postoperative hospital stay time in the elderly patients with SAIS undergoing arthroscopic acromioplasty.