目的:观察快速康复外科(ERAS)理念指导下围手术期护理干预措施对机器人辅助全膝关节置换术患者的临床应用及效果评价。方法:选取新疆医科大学第六附属医院2023年8月至2024年4月在腰硬联合麻醉下行单侧机器人辅助全膝关节置换术的患者75...目的:观察快速康复外科(ERAS)理念指导下围手术期护理干预措施对机器人辅助全膝关节置换术患者的临床应用及效果评价。方法:选取新疆医科大学第六附属医院2023年8月至2024年4月在腰硬联合麻醉下行单侧机器人辅助全膝关节置换术的患者75例,分为对照组36例和观察组39例。对照组采用常规围手术期护理干预措施,观察组采用ERAS理念指导下围手术期护理干预措施。比较两组围手术期指标(术后首次下床活动时间、尿管拔除时间)、术后视觉模拟评分法(VAS)评分、美国特种外科医院(HSS)评分、美国膝关节协会(KSS)评分、膝关节主动活动度(ROM)、护理满意度及住院时间。结果:与对照组相比,采取ERAS理念指导下围手术期护理干预措施后,观察组术后首次下床活动时间为(23.06 ± 1.17)小时,尿管拔除时间为(6.82 ± 0.76)小时,均短于对照组,差异具有统计学意义(P Objective: To observe the clinical application and effect evaluation of perioperative nursing interventions guided by the concept of rapid recovery surgery (ERAS) on patients undergoing robot-assisted total knee arthroplasty. Methods: A total of 75 patients undergoing unilateral robot-assisted total knee arthroplasty under combined spinal-epidural anesthesia from August 2023 to April 2024 in the Sixth Affiliated Hospital of Xinjiang Medical University were enrolled, and they were divided into control group (36 cases) and observation group (39 cases). The control group was treated with conventional perioperative nursing interventions, and the observation group was guided by ERAS concept. The perioperative indexes (time to first get out of bed after surgery, time to urethral catheter removal), postoperative visual analogue scale (VAS) score, American Hospital for Special Surgery (HSS) score, American Knee Association (KSS) score, knee active range of motion (ROM), nursing satisfaction and hospital stay were compared between the two groups. Results: Compared with the control group, the time of first postoperative activity and the time of urethral catheter removal in the observation group were (23.06 ± 1.17) hours, and the time of urethral catheter removal was (6.82 ± 0.76) hours, which were shorter than those in the control group, and the difference was statistically significant (P < 0.05), and the VAS score of the observation group was (4.46 ± 0.79) on the first day after operation, and (2.21 ± 0.66) on the seventh day after operation. The HSS score was (59.31 ± 2.36) on the seventh day and (81.38 ± 2.16) on the first month after operation. The KSS score in the first month after surgery was (78.38 ± 2.20). The ROM in the first month after surgery was (110.00±2.56);The nursing satisfaction score at discharge was (95.79 ± 0.81). The average length of hospital stay was (11.15 ± 1.25) days, which was better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: Perioperative nursing measures under the guidance of ERAS concept have good clinical application value in accelerating the knee rehabilitation process of patients undergoing robotic total knee arthroplasty.展开更多
目的探究国产机器人辅助全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)的影像学精准度和临床疗效。方法采用前瞻随机对照研究,以2021年10月至2022年3月期间符合纳入排除标准的拟行TKA手术的患者为研究对象,最终共纳入2...目的探究国产机器人辅助全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)的影像学精准度和临床疗效。方法采用前瞻随机对照研究,以2021年10月至2022年3月期间符合纳入排除标准的拟行TKA手术的患者为研究对象,最终共纳入23例患者。通过随机信封法分为RATKA组和传统TKA组。RATKA组患者11例,男3例,女8例;平均年龄(68.7±7.8)岁。传统TKA组患者12例,男1例,女11例;平均年龄(70.8±5.0)岁。测算两组患者下肢力线和假体位置角度以评估影像学精准度,记录两组手术时间、失血量、功能评分、围术期并发症等以评估临床疗效结果。结果影像学精准度指标上,RATKA组的髋-膝-踝角(hip-knee-ankle angle,HKA)偏离值小于传统TKA组,分别为(1.16±1.14)°及(2.56±1.90)°,P=0.047;矢状面胫骨角(lateral tibia component,LTC)偏离值也小于传统TKA组,分别为(0.95±0.71)°及(1.75±0.98)°,P=0.039;其余角度的偏离值比较差异无统计学意义(P>0.05)。临床疗效指标上,RATKA组总手术时间较传统TKA组延长,分别为(125.0±8.4)min及(101.0±28.5)min,P=0.027;在截骨时间、围术期失血量、膝关节活动度(range of motion,ROM)及功能评分上差异无统计学意义(P>0.05)。两组患者围术期并发症发生率差异无统计学意义(P>0.05)。结论国产机器人在辅助行初次人工全膝关节置换时可以提高下肢力线重建和矢状位胫骨假体安装的精准度,且安全可靠,值得在临床中推广应用。展开更多
目的通过前瞻性随机对照研究,探讨国产机器人辅助人工全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)治疗膝骨关节炎的早期疗效。方法以2021年8月至2022年1月拟接受初次单侧全膝关节置换术(total knee arthroplasty,TKA...目的通过前瞻性随机对照研究,探讨国产机器人辅助人工全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)治疗膝骨关节炎的早期疗效。方法以2021年8月至2022年1月拟接受初次单侧全膝关节置换术(total knee arthroplasty,TKA)的18例患者作为研究对象,根据随机数字表法分为传统TKA组和RATKA组,每组9例患者。传统TKA组男3例,女6例;平均年龄(70.00±10.63)岁。RATKA组男3例,女6例;平均年龄(68.22±6.12)岁。记录两组手术时间、术中出血量、术后住院天数、术后血红蛋白(hemoglobin,HB)及红细胞比容(hematocrit,HCT);采用活动度(range of motion,ROM)、膝关节学会评分系统(knee society score,KSS)评分以及西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)关节炎指数疼痛、僵硬、功能评分,评估膝关节功能及疼痛情况;拍摄双下肢全长正位及单侧膝关节侧位X线片,测算髋-膝-踝角(hip-knee-ankle angle,HKA)偏移程度及股骨远端外侧角(lateral distal femoral angle,LDFA)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、关节汇聚角(joint lineconvergence angle,JLCA)等,评价下肢力线及假体植入位置。结果两组手术均顺利完成;术后切口均Ⅰ期愈合,无手术相关并发症发生。RATKA组手术时间较传统TKA组延长(P=0.002),两组患者术中出血量、术后引流量、术后HB及HCT减少量等组间比较,差异均无统计学意义(P>0.05)。术后5个月随访,两组膝关节ROM、KSS评分以及WOMAC疼痛、僵硬、功能评分均较术前改善,差异有统计学意义(P<0.05);上述指标手术前后差值组间比较,差异均无统计学意义(P>0.05)。RATKA组术后HKA偏移明显优于传统TKA组,差异有统计学意义(P<0.05)。两组术后LDFA及MPTA比较,差异均无统计学意义(P>0.05);RATKA组JLCA小于传统TKA组(P<0.05),更接近理想值。结论采用国产机器人行RATKA能提高假体安放位置以及下肢力线精准度,获得较好早期疗效,远期疗效有待进一步观察。展开更多
文摘目的:观察快速康复外科(ERAS)理念指导下围手术期护理干预措施对机器人辅助全膝关节置换术患者的临床应用及效果评价。方法:选取新疆医科大学第六附属医院2023年8月至2024年4月在腰硬联合麻醉下行单侧机器人辅助全膝关节置换术的患者75例,分为对照组36例和观察组39例。对照组采用常规围手术期护理干预措施,观察组采用ERAS理念指导下围手术期护理干预措施。比较两组围手术期指标(术后首次下床活动时间、尿管拔除时间)、术后视觉模拟评分法(VAS)评分、美国特种外科医院(HSS)评分、美国膝关节协会(KSS)评分、膝关节主动活动度(ROM)、护理满意度及住院时间。结果:与对照组相比,采取ERAS理念指导下围手术期护理干预措施后,观察组术后首次下床活动时间为(23.06 ± 1.17)小时,尿管拔除时间为(6.82 ± 0.76)小时,均短于对照组,差异具有统计学意义(P Objective: To observe the clinical application and effect evaluation of perioperative nursing interventions guided by the concept of rapid recovery surgery (ERAS) on patients undergoing robot-assisted total knee arthroplasty. Methods: A total of 75 patients undergoing unilateral robot-assisted total knee arthroplasty under combined spinal-epidural anesthesia from August 2023 to April 2024 in the Sixth Affiliated Hospital of Xinjiang Medical University were enrolled, and they were divided into control group (36 cases) and observation group (39 cases). The control group was treated with conventional perioperative nursing interventions, and the observation group was guided by ERAS concept. The perioperative indexes (time to first get out of bed after surgery, time to urethral catheter removal), postoperative visual analogue scale (VAS) score, American Hospital for Special Surgery (HSS) score, American Knee Association (KSS) score, knee active range of motion (ROM), nursing satisfaction and hospital stay were compared between the two groups. Results: Compared with the control group, the time of first postoperative activity and the time of urethral catheter removal in the observation group were (23.06 ± 1.17) hours, and the time of urethral catheter removal was (6.82 ± 0.76) hours, which were shorter than those in the control group, and the difference was statistically significant (P < 0.05), and the VAS score of the observation group was (4.46 ± 0.79) on the first day after operation, and (2.21 ± 0.66) on the seventh day after operation. The HSS score was (59.31 ± 2.36) on the seventh day and (81.38 ± 2.16) on the first month after operation. The KSS score in the first month after surgery was (78.38 ± 2.20). The ROM in the first month after surgery was (110.00±2.56);The nursing satisfaction score at discharge was (95.79 ± 0.81). The average length of hospital stay was (11.15 ± 1.25) days, which was better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: Perioperative nursing measures under the guidance of ERAS concept have good clinical application value in accelerating the knee rehabilitation process of patients undergoing robotic total knee arthroplasty.
文摘目的探究国产机器人辅助全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)的影像学精准度和临床疗效。方法采用前瞻随机对照研究,以2021年10月至2022年3月期间符合纳入排除标准的拟行TKA手术的患者为研究对象,最终共纳入23例患者。通过随机信封法分为RATKA组和传统TKA组。RATKA组患者11例,男3例,女8例;平均年龄(68.7±7.8)岁。传统TKA组患者12例,男1例,女11例;平均年龄(70.8±5.0)岁。测算两组患者下肢力线和假体位置角度以评估影像学精准度,记录两组手术时间、失血量、功能评分、围术期并发症等以评估临床疗效结果。结果影像学精准度指标上,RATKA组的髋-膝-踝角(hip-knee-ankle angle,HKA)偏离值小于传统TKA组,分别为(1.16±1.14)°及(2.56±1.90)°,P=0.047;矢状面胫骨角(lateral tibia component,LTC)偏离值也小于传统TKA组,分别为(0.95±0.71)°及(1.75±0.98)°,P=0.039;其余角度的偏离值比较差异无统计学意义(P>0.05)。临床疗效指标上,RATKA组总手术时间较传统TKA组延长,分别为(125.0±8.4)min及(101.0±28.5)min,P=0.027;在截骨时间、围术期失血量、膝关节活动度(range of motion,ROM)及功能评分上差异无统计学意义(P>0.05)。两组患者围术期并发症发生率差异无统计学意义(P>0.05)。结论国产机器人在辅助行初次人工全膝关节置换时可以提高下肢力线重建和矢状位胫骨假体安装的精准度,且安全可靠,值得在临床中推广应用。
文摘目的通过前瞻性随机对照研究,探讨国产机器人辅助人工全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)治疗膝骨关节炎的早期疗效。方法以2021年8月至2022年1月拟接受初次单侧全膝关节置换术(total knee arthroplasty,TKA)的18例患者作为研究对象,根据随机数字表法分为传统TKA组和RATKA组,每组9例患者。传统TKA组男3例,女6例;平均年龄(70.00±10.63)岁。RATKA组男3例,女6例;平均年龄(68.22±6.12)岁。记录两组手术时间、术中出血量、术后住院天数、术后血红蛋白(hemoglobin,HB)及红细胞比容(hematocrit,HCT);采用活动度(range of motion,ROM)、膝关节学会评分系统(knee society score,KSS)评分以及西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)关节炎指数疼痛、僵硬、功能评分,评估膝关节功能及疼痛情况;拍摄双下肢全长正位及单侧膝关节侧位X线片,测算髋-膝-踝角(hip-knee-ankle angle,HKA)偏移程度及股骨远端外侧角(lateral distal femoral angle,LDFA)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、关节汇聚角(joint lineconvergence angle,JLCA)等,评价下肢力线及假体植入位置。结果两组手术均顺利完成;术后切口均Ⅰ期愈合,无手术相关并发症发生。RATKA组手术时间较传统TKA组延长(P=0.002),两组患者术中出血量、术后引流量、术后HB及HCT减少量等组间比较,差异均无统计学意义(P>0.05)。术后5个月随访,两组膝关节ROM、KSS评分以及WOMAC疼痛、僵硬、功能评分均较术前改善,差异有统计学意义(P<0.05);上述指标手术前后差值组间比较,差异均无统计学意义(P>0.05)。RATKA组术后HKA偏移明显优于传统TKA组,差异有统计学意义(P<0.05)。两组术后LDFA及MPTA比较,差异均无统计学意义(P>0.05);RATKA组JLCA小于传统TKA组(P<0.05),更接近理想值。结论采用国产机器人行RATKA能提高假体安放位置以及下肢力线精准度,获得较好早期疗效,远期疗效有待进一步观察。
