| 王薇,李颂,赵慧,等.加速康复外科理念在青少年特发性脊柱侧凸围术期的应用.骨科,2021,12(5): 462-466. |
| 加速康复外科理念在青少年特发性脊柱侧凸围术期的应用 |
| Application of the Concept of Enhanced Recovery after Surgery in the Rehabilitation of Adolescent Idiopathic Scoliosis |
| 投稿时间：2021-04-20 |
| DOI：10.3969/j.issn.1674-8573.2021.05.014 |
| 中文关键词: 加速康复外科 青少年特发性脊柱侧凸 炎症因子 生活质量 疼痛 |
| 英文关键词: Enhanced recovery after surgery Adolescent idiopathic scoliosis Inflammatory factors Quality of life Pain |
| 基金项目:哈尔滨市科技创新人才研究专项资金项目（2017RAQXJ185） |
|
| 摘要点击次数: 2895 |
| 全文下载次数: 2690 |
| 中文摘要: |
| 目的 探讨加速康复外科（ERAS）在手术治疗青少年特发性脊柱侧凸（AIS）病人中的应用效果。方法 收集2016年1月至2020年12月在我院接受AIS手术治疗的138例病人的病例资料。将2016年1月至2018年6月给予常规围术期管理措施的69例病人纳入对照组，2018年7月至2020年12月进行ERAS理念管理的69例病人纳入观察组，进行对照研究。记录两组病人手术时间、出血量、术后输血人数等指标，以及手术前后疼痛程度、心理状况、生活质量和炎症因子变化。结果 观察组手术时间、出血量、术后输血人数、并发症发生率和住院时间均低于对照组（P＜0.05），观察组护理满意度高于对照组（92.75% vs. 73.91%，P=0.003）。观察组术后24 h、3 d的疼痛视觉模拟量表（VAS）评分低于对照组（P＜0.05）；而术后7 d的VAS评分与对照组比较，差异无统计学意义（P＞0.05）。两组术后7 d的焦虑自评量表、抑郁自评量表、简体中文版脊柱侧凸研究学会22项问卷表评分，以及血清白细胞介素-6、肿瘤坏死因子α水平与术前比较，差异均有统计学意义（P均＜0.05）；两组间比较，观察组明显低于对照组，差异均有统计学意义（P均＜0.05）。结论 ERAS能减少AIS病人围术期失血和不良反应，有利于疼痛的早期控制，降低炎症因子，减轻不良情绪，提高生活质量，进而促进病人早期康复。 |
| 英文摘要: |
| Objective To explore the role of enhanced recovery after surgery (ERAS) in the rehabilitation of adolescent idiopathic scoliosis (AIS). Methods The clinical data of 138 patients with AIS who underwent surgical treatment in our hospital from January 2016 to December 2020 were continuously collected. According to the time of ERAS application, the patients were divided into study group (from July 2018 to December 2020) and control group (from January 2016 to June 2018) with 69 cases each. The control group was given routine perioperative management measures, and the study group was given ERAS concept management. The operation time, blood loss, number of postoperative blood transfusion, the changes in preoperative and postoperative pain, psychological status, quality of life, and inflammatory factors of two groups were recorded. Results The operation time, blood loss, number of postoperative blood transfusion, incidence of complications and hospital stay in the study group were significantly reduced as compared with those in the control group (P＜0.05), and the patients in study group were more satisfactory than in the control group (92.75% vs. 73.91%, P=0.003). The visual analogue scale (VAS) scores in the study group were significantly lower than those in the control group at 24 h and 3 days after surgery (P＜0.05). There was no significant difference in VAS score at 7 days after surgery between two groups (P＞0.05). Scores of Chinese version of Scoliosis Research Society 22-item questionnaire, anxiety self-rating scale, depression self-rating scale and levels of serum interleukin-6 and tumor necrosis factor alpha in the two groups at 7th day after surgery were significantly lower than those before surgery (P＜0.05), and those in the study group were significantly lower than those in the control group (P＜0.05). Conclusion ERAS can reduce perioperative blood loss and adverse reactions in patients with AIS, early control pain, reduce inflammatory factors, reduce negative emotions, improve quality of life, and promote early recovery of patients. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
