摘要
目的在初次单髋全髋关节置换术中应用快速康复理念,并通过检测患者的各项指标对其有效性进行评价。方法选取2015年9月~2016年9月我科进行的单髋全髋关节置换术患者74例,按编号随机分为两组。常规治疗组36例采用改良后外侧切口,使用De Puy CORAIL系统的人工髋关节假体,术后给予选择性非甾体抗炎药(NSAIDs)止痛治疗,并配合康复训练。快速康复组38例在常规治疗组基础上分别在术前、术中及术后进行干预。术后比较两组患者疼痛指数、血红蛋白下降率、影像学评价、并发症、髋关节功能Harris评分、住院天数及住院费用。结果两组患者在发生严重并发症、髋关节术后X线检查(髋臼杯外展角及前倾角)、术后第1~3 d的静息疼痛VAS评分方面,差异均无统计学意义(P>0.05)。快速康复组的第1~3 d负重VAS评分、血红蛋白下降率及住院天数、住院费用分别为(2.34±1.21)分、(2.12±1.02)分、(13.21±7.83)%、(9.37±3.13)d及(1.85±0.32)万元,低于常规治疗组的(3.82±1.46)分、(3.06±1.21)分、(17.23±8.45)、(12.43±3.38)d及(2.01±0.37)万元,差异具有统计学意义(P<0.05)。快速康复组出院当日及术后3个月髋关节Harris评分,高于常规治疗组,差异具有统计学意义(P<0.05)。结论快速康复应用于全髋关节置换术,能有效促进患者的功能康复、缩短住院时间、降低住院费用。
Objective To apply the concept of rapid rehabilitation in the initial single hip total hip arthroplasty and evaluate the effectiveness of the patients by testing their indicators.Methods 74 patients with single hip total hip arthroplasty who underwent surgery from September 2015 to September 2016 were randomly divided into two groups according to the number.36 patients in the conventional treatment group underwent modified posterolateral incision,using the artificial hip joint prosthesis of De Puy CORAIL system,and postoperative analgesic treatment with selective non-steroidal anti-inflammatory drugs（NSAIDs）,combined with rehabilitation training.38 patients in the rapid rehabilitation group underwent preoperative,intraoperative and postoperative intervention on the basis of the conventional treatment group.Pain index,hemoglobin decline rate,imaging evaluation,complications,hip function Harris score,length of hospital stay and hospitalization expenses were compared between the two groups.Results There were no significant differences between the two groups in terms of serious complications,X-ray examination of the hip joint（acetabular cup abduction angle and anteversion）,and resting pain VAS scores at 1 to 3 d after surgery,the difference was not statistically significant（ P〉0.05）.The 1 st to 3 rd d weight-bearing VAS score,hemoglobin decline rate,hospitalization days,and hospitalization expenses in the rapid rehabilitation group were（2.34±1.21）points,（2.12±1.02）points,（13.21±7.83）%,（9.37±3.13）dand（1.85±0.32）million,lower than（3.82±1.46）points,（3.06±1.21）points,（17.23±8.45）,（12.43±3.38）d and（2.01±0.37）million,the difference was statistically significant（P〈0.05）.The hip Harris score on the day of discharge and 3 months after surgery in the rapid rehabilitation group was higher than that in the conventional treatment group,and the difference was statistically significant（P〈0.05）.Conclusion Rapid rehabilitation is applied to total hip arthroplasty,which can effectively promote functional rehabilitation,shorten hospitalization,and reduce hospitalization costs.
作者
李涛
裴建祥
陈小龙
宋奇志
张峡
LI Tao;PEI Jian-xiang;CHEN Xiao-long;SONG Qi-zhi;ZHANG Xia(Department of Orthopedics,Chongqing Heavy Steel General Hospital,Chongqing 400081,China;Department of Orthopedics,Xinqiao Hospital Affiliated to Army Medical University,Chongqing 400037,China)
出处
《医学信息》
2018年第13期104-106,109,共4页
Journal of Medical Information
