快速康复外科理念在髋膝关节置换术中的应用效果探讨

Application effect of the concept of fast-track surgery in hip or knee replacement

目的 探讨快速康复外科理念在髋膝关节置换术中的应用效果。方法 选取接受髋膝关节置换术治疗的80例患者,以电脑随机法分为试验组与对照组,各40例。对照组接受传统模式护理,试验组接受快速康复外科理念护理。比较两组护理前后的相关评分[美国特种外科医院(HSS)评分、视觉模拟评分法(VAS)评分、髋关节功能评分标准(Harris)评分、恐动症评分量表(TSK)评分]、关节主动活动度(ROM)、生活质量评分及各项时间指标、住院费用、并发症发生率、护理满意度、护理优良率、ROM恢复到60、80、100、120°的时间。结果 护理后,试验组HSS评分、VAS评分、ROM、Harris评分、TSK评分明显优于对照组(P<0.05)。护理后,试验组生理机能评分(93.82±5.21)分、精神健康评分(92.07±5.15)分、情感职能评分(90.95±5.46)分、活力评分(90.87±5.09)分明显优于对照组的(84.71±4.21)、(80.83±4.25)、(81.52±4.49)、(81.01±4.32)分(P<0.05)。试验组首次下床活动时间(1.76±0.93)d、导管拔除时间(21.09±7.07)h、住院时间(7.17±2.01)d、进食时间(2.87±0.09)h、首次排尿时间(23.79±0.65)h、住院费用(27024.17±2432.62)元均明显优于对照组的(2.95±1.05)d、(43.52±16.31)h、(10.32±2.91)d、(5.81±0.59)h、(47.63±0.47)h、(32758.41±3593.89)元(P<0.05)。试验组并发症发生率5.00%优于对照组的22.50%(P<0.05)。试验组总满意度97.50%明显优于对照组的77.50%(P<0.05)。试验组的护理优良率97.50%明显高于对照组的77.50%(P<0.05)。试验组ROM恢复到60、80、100、120°的时间明显短于对照组(P<0.05)。结论 快速康复外科理念应用于髋膝关节置换术中具有良好的效果。

Objective To explore the application effect of the concept of fast-track surgery in hip or knee replacement.Methods A total of 80 patients with hip or knee replacement were divided into an experimental group and a control group according to computer random grouping method,with 40 cases in each group.The control group received the traditional nursing mode,and the experimental group received nursing based on concept of fast-track surgery.Comparison was made on related scores[Hospital for Special Surgery(HSS)score,Visual Analogue Scale(VAS)score,Harris score,Tampa Scale for Kinesiophopia(TSK)score],range of motion(ROM),quality of life score and time indicators before and after nursing,hospitalization cost,complication rate,nursing satisfaction,nursing excellence rate,time to ROM recovery to 60,80,100,120°.Results After nursing,HSS score,VAS score,ROM,Harris score and TSK score in the experimental group were obviously better than those in the control group(P<0.05).After nursing,the experimental group had physiological function score of(93.82±5.21)points,mental health score of(92.07±5.15)points,emotional function score of(90.95±5.46)points,and vitality score of(90.87±5.09)points,which were significantly better than(84.71±4.21),(80.83±4.25),(81.52±4.49),and(81.01±4.32)points in the control group(P<0.05).In the experimental group,the time to first ambulation was(1.76±0.93)d,the time to catheter removal was(21.09±7.07)h,the hospitalization time was(7.17±2.01)d,the time of eating was(2.87±0.09)h,the time of first urination was(23.79±0.65)h,the hospitalization cost was(27024.17±2432.62)yuan,which were significantly better than(2.95±1.05)d,(43.52±16.31)h,(10.32±2.91)d,(5.81±0.59)h,(47.63±0.47)h,(32758.41±3593.89)yuan in the control group(P<0.05).The incidence of complications of 5.00%in the experimental group was better than 22.50%in the control group(P<0.05).The total satisfaction rate of 97.50%in the experimental group was obviously better than 77.50%in the control group(P<0.05).The excellent nursing rate of 97.50%in the experimental group was obviously higher than 77.50%in the control group(P<0.05).The time to ROM recovery to 60,80,100,120°in the experimental group was obviously shorter than those in the control group(P<0.05).Conclusion Application of concept of fast-track surgery in hip or knee replacement has good effect.