| 马子君,张爽,鲁楠.加速康复外科在关节镜下半月板损伤修复围术期护理中的应用.骨科,2018,9(5): 400-405. |
| 加速康复外科在关节镜下半月板损伤修复围术期护理中的应用 |
| Concepts of enhanced recovery after surgery applied to perioperative nursing of arthroscopic surgery for meniscus injury |
| 投稿时间：2017-11-02 |
| DOI：10.3969/j.issn.1674-8573.2018.05.013 |
| 中文关键词: 加速康复外科 关节镜检查 半月板损伤 围术期护理 |
| 英文关键词: Enhanced recoverry after surgery Arthroscopy Meniscus injury Perioperative nursing |
| 基金项目: |
|
| 摘要点击次数: 4053 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 探讨加速康复外科（enhanced recovery after surgery, ERAS）优化方案在关节镜下半月板损伤修复围术期护理的应用效果。方法 选取2017年1月至6月在北京积水潭医院运动医学科收治的膝关节半月板损伤病人90例，按照随机数字表法分为ERAS组和常规组，每组45例。ERAS组围术期在常规护理方法的基础上，给予改进的ERAS优化护理方案。比较两组病人术后疼痛视觉模拟量表（visual analogue score, VAS）评分、膝关节活动度恢复时间、Lysholm膝关节评分（Lysholm knee score scale, LKSS）、住院时间和费用、术后并发症及术后满意度情况。结果 两组病人术前至术后48 h各时间点的VAS评分均呈下降趋势（FERAS组=14.355，F常规组=5.728，P均＜0.05），从各个时间点看，ERAS组的VAS评分值显著低于常规组（F组间=11.937，P组间=0.001），不同时间点与分组之间存在交互作用（F交互=16.571，P交互＜0.001）；ERAS组术后膝关节活动度恢复至30°、60°、90°及120°时间明显早于常规组（P＜0.001），且病人住院时间短（t=-5.181，P＜0.001）、住院费用低（t=-3.263，P=0.002）、术后Lysholm膝关节评分更佳（t=10.682，P＜0.001）；ERAS组病人术后恶心、呕吐、尿潴留、关节积液等并发症发生率较常规组低（P＜0.05），总体满意度明显高于常规组（Z=-2.455，P=0.014）。结论 ERAS优化方案应用于关节镜下半月板损伤修复的围术期护理中效果显著，可明显降低病人术后疼痛程度，缩短住院时间，减少住院总费用和并发症发生率，有效改善病人早期及远期膝关节活动情况，提高病人治疗综合满意度。 |
| 英文摘要: |
| Objective To explore the effect of enhanced recoverry after surgery (ERAS) optimizations in the arthroscopy surgery for meniscus injury. Methods Ninety patients with meniscus injury, who were treated in the Department of Sports Medicine in Beijing Jishuitan Hospital from January to June 2017 were divided into ERAS group (n=45) and conventional group (n=45) according to the random number table. The ERAS group was given an optimized ERAS nursing plan during the perioperative period on the basis of the conventional nursing methods. The visual analogue score (VAS), the recovery time of the knee joint, the LKSS score, the hospitalization duration, cost, postoperative complications and postoperative satisfaction were compared. Results The VAS scores in both groups decreased at different time points (FERAS group=14.355 and Fconventional group=5.728, P＜0.05). From all the points, the data of ERAS group were significantly lower than the conventional group (Fgroup=11.937, Pgroup=0.001). There was interaction between different time and groups (Finteraction=16.571, Pinteraction＜0.001). The postoperative knee range of motion returned to 30°, 60°, 90° and 120° faster (P＜0.001), the length of hospital stay was shorter (t=-5.181, P＜0.001), hospitalization cost was lowere (t=-3.263, P=0.002), and the LKSS score was better (t=10.682, P＜0.001) in the ERAS group than in the conventional group. The incidence of complications such as nausea, vomiting, urinary retention and joint effusion was lower (P＜0.05), and the overall satisfaction rate was significantly higher (Z=-2.455, P=0.014) in the ERAS group than in the conventional group. Conclusion The effect of ERAS optimizations in the arthroscopic surgery for meniscus injury is significant. It can reduce the degree of postoperative pain, the length of hospital stay, the total cost of hospitalization and complications significantly. It can also effectively improve the early and long-term knee joint activity, and improve the satisfaction of patients. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
