摘要
目的探讨基于加速康复外科(ERAS)理念的全流程精细化护理在膝关节单髁置换术(UKA)围术期的应用效果。方法选择2020年1月至2023年12月在河南省直第三人民医院骨科接受UKA治疗的115例患者展开研究,按随机数表法分为观察组58例和对照组57例。对照组患者采用常规护理,观察组患者采用基于ERAS理念的全流程精细化护理,两组患者均护理至出院,均随访1个月后回院复查。护理结束出院前,比较两组患者的围术期情况(包括术中失血量、术后下床时间和住院时间),以及术前和术后24 h、48 h的视觉模拟评分法(VAS)评分;回院复查时,比较两组患者术前及随访1个月后的美国特种外科医院膝关节评分(HSS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分;护理结束出院前,比较两组患者的并发症发生率。结果观察组患者的术中失血量(234.12±31.82)m L、术后下床时间(13.27±2.65)h、住院时间分别为(3.02±0.57)d,明显少(短)于对照组的(251.84±28.45)m L、(17.02±2.77)h、(3.60±0.64)d,差异均有统计学意义(P<0.05);观察组患者术后24 h的VAS评分为(3.14±0.69)分、术后48 h为(2.38±0.63)分,明显低于对照组的(3.73±0.79)分、(2.90±0.66)分,差异均有统计学意义(P<0.05);随访1个月后,观察组患者的HSS评分为(71.34±6.83)分,明显高于对照组的(65.38±6.16),WOMAC评分为(32.02±4.37)分,明显低于对照组的(36.95±4.64)分,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为3.45%,略低于对照组的5.26%,但差异无统计学意义(P>0.05)。结论基于ERAS理念的全流程精细化护理在UKA患者围术期的应用有助于缓解患者术后疼痛、促进关节功能早期恢复,值得临床推广应用。
Objective To investigate the effect of whole-process intensive nursing based on the concept of en-hanced recovery after surgery(ERAS)in the perioperative period of unicondylar knee replacement(UKA).Methods A total of 115 patients who received UKA treatment in Department of Orthopaedics,the Third People's Hospital of Henan Province from January 2020 to December 2023 were selected and divided into an observation group(58 cases)and a con-trol group(57 cases)according to random number table method.Patients in the control group received routine nursing,and patients in the observation group received whole-process refined nursing based on the concept of ERAS.Both groups of patients were cared until discharge.All the patients were followed up for 1 month and returned to the hospital for re-ex-amination.Before discharge,the perioperative conditions(including intraoperative blood loss,time of getting out of bed after operation,and length of hospital stay)of the two groups were compared,as well as Visual Analogue Scale(VAS)scores before surgery and at 24 h,48 h after surgery.The knee joint score of the Hospital for Special Surgery(HSS)and the osteoarthritis index of Western Ontario and McMaster University(WOMAC)were compared between the two groups before surgery and after follow-up.At discharge,the incidences of complications were compared between the two groups.Results The intraoperative blood loss,time of getting out of bed after operation,and length of hospital stay in the observation group were(234.12±31.82)mL,(13.27±2.65)h,and(3.02±0.57)d,which were significantly less(short-er)than(251.84±28.45)mL,(17.02±2.77)h,(3.60±0.64)d in the control group(P<0.05).The VAS scores at 24 h,48 h after surgery in the observation group were(3.14±0.69)points,(2.38±0.63)points,respectively,which were significantly low-er than(3.73±0.79)points,(2.90±0.66)points in the control group(P<0.05).After follow up for 1 month,the HSS score in the observation group was(71.34±6.83)points,which was significantly higher than(65.38±6.16)points in the control group,and the WOMAC score was(32.02±4.37)points,which was significantly lower than(36.95±4.64)points in the control group,with statistically significant differences(P<0.05).The total incidence of complications in the observation group was 3.45%,slightly lower than 5.26%in the control group(P>0.05).Conclusion The whole-process refined nursing based on the concept of ERAS have significant effect in the perioperative period of UKA patients,which can help relieve patientss’postoperative pain and promote early recovery of joint function,which is worthy of clinical application.
作者
刘东方
胡彬
延净德
王玉香
王德平
LIU Dong-fang;HU Bin;YAN Jing-de;WANG Yu-xiang;WANG De-ping(Department of Orthopedics,the Third People's Hospital of Henan Province,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第15期2260-2264,共5页
Hainan Medical Journal
基金
河南省医学科技攻关项目(编号:SBGJ202102201)。
关键词
膝关节单髁置换术
加速康复外科理念
精细化护理
疼痛
关节功能
并发症
Unicondylar knee replacement
Enhanced recovery after surgery
Refined nursing
Pain
Joint func-tion
Complication
