| 聂琨,张卫国,汪阳.快速康复外科在前交叉韧带止点骨折关节镜下VERSALOK锚钉内固定围术期的应用.骨科,2017,8(6): 473-476. |
| 快速康复外科在前交叉韧带止点骨折关节镜下VERSALOK锚钉内固定围术期的应用 |
| Perioperative application of enhanced recovery after surgery principles in fixation for the arthroscopic treatment of avulsion fracture of the tibial attachment of the anterior cruciate ligament using VERSLOCK anchor screw |
| 投稿时间：2017-06-04 |
| DOI：10.3969/j.issn.1674-8573.2017.06.012 |
| 中文关键词: 快速康复外科 关节镜检查 前交叉韧带 骨折 |
| 英文关键词: Enhanced recovery after surgery Arthroscopy Anterior cruciate ligament Fractures |
| 基金项目:武汉市卫生局科研项目资助（WX15C38） |
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| 中文摘要: |
| 目的 探讨快速康复外科（enhanced recovery after surgery, ERAS）理念在关节镜下全内VERSALOK锚钉固定前交叉韧带止点撕脱性骨折围手术期中的应用。方法 我科2014年1月至2016年12月进行关节镜下全内VERSALOK锚钉治疗前交叉韧带止点撕脱性骨折病人24例，男16例，女8例；年龄为13~45岁，平均27.0岁。受伤至入院时间为1~3 d。对24例膝关节前交叉韧带止点撕脱性骨折病人在围手术期实施ERAS综合措施。记录病人择期手术并发症发生率、平均住院时间、病人出院满意度，术后3 d、1个月、3个月疼痛视觉模拟量表（visual analogue scale, VAS）评分及膝关节Lysholm评分。结果 术后病人满意度≥95%，术后平均住院时间为（6.2±0.5） d。病人均获得随访，随访时间为6~24个月，平均（14.0±1.4）个月。术后3 d、1个月、3个月，VAS评分分别为（4.0±0.8）分、（2.0±0.5）分、（1.0±0.6）分；Lysholm膝关节评分分别为（86.7±3.7）分、（90.6±3.7）分、（94.2±2.1）分，VAS评分和Lysholm膝关节评分术后1个月、3个月与术后3 d比较，术后3个月与术后1个月比较，差异均有统计学意义（均P＜0.05）。结论 ERAS应用于关节镜下全内VERSALOK锚钉固定前交叉韧带止点撕脱性骨折，病人术后关节活动好、疼痛明显减轻，改善了病人疼痛，缩短了住院时间，促进了病人康复，病人满意度高。 |
| 英文摘要: |
| Objective To investigate the perioperative application of enhanced recovery after surgery (ERAS) principles in arthroscopic total internal VERSALOK anchor screw fixation for avulsion fracture of the tibial attachment of anterior cruciate ligament. Methods There were a total of 24 cases (16 males and 8 females) of avulsion fracture of the tibial attachment of anterior cruciate ligament from January 2014 to December 2016 in our department, and their average age was 27.0 years old (ranging from 13-45 years old). All patients underwent fixation with VERSALOK anchor screw by arthroscopy with ERAS principles during perioperative period. At 3rd day, 1st month, and 3rd month after surgery, visual analogue scale (VAS) score and Lysholm score were recorded. The complication rate of elective surgery, hospital stay, and satisfaction of patients were monitored. Results Postoperative satisfaction was greater than 95%. The postoperative average length of hospital stay was (6.2±0.5) days. All patients were followed up for 6-24 months (mean 14.0±1.4 months). The VAS scores at 3rd day, 1st month, and 3rd month after surgery were (4.0±0.8), (2.0±0.5) and (1.0±0.6) respectively (paired test, t=22.243, P=0.000), and the Lysholm scores were (86.7±3.7), (90.6±3.7) and (94.2±2.1) respectively (paired test, t=20.131, P=0.000). The comparisons between 1st month or 3rd month and 3rd day, or between 3rd month and 1st month after surgery showed significant difference (P＜0.05 for all). Conclusion The application of ERAS in arthroscopic total VERSALOK anchor fixation for anterior cruciate ligament avulsion fracture can obtain postoperatively satisfactory joint activities, alleviate patients' pain, shorten the duration of hospitalization, promote the rehabilitation of patients. |
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