快速康复外科在重度骨关节炎患者一期双侧膝关节置换术中的应用

摘要

目的 探讨快速康复外科(ERAS)在重度骨关节炎患者一期双侧膝关节置换术中的应用效果.方法 回顾性分析50例因双膝重度骨关节炎择期行一期双膝关节置换术患者的临床资料,根据围术期管理方法分为ERAS组26例及对照组24例.比较两组患者术后1周、1个月、3个月及6个月疼痛视觉模拟(VAS)评分、特种外科医院(HSS)膝关节评分、膝关节活动度(ROM)、术后并发症发生率、术后住院时间及患者满意度.结果 ERAS组患者术后膝关节VAS评分低于对照组,HSS 评分及 ROM 高于对照组(均P<0.05),两组膝关节 VAS、HSS 评分及 ROM 均有随时间变化的趋势(均P<0.05),但分组与时间均无交互作用(均P>0.05).ERAS组术后住院时间短于对照组,患者满意度高于对照组,且术后切口愈合不良发生率、深静脉血栓发生率及泌尿系感染发生率均低于对照组(均P<0.05).结论 在重度骨关节一期双侧膝关节置换术应用ERAS可促进患者早期康复,降低患者疼痛感受,缩短住院时间,并提高患者满意度.%Objective To explore the effect of enhanced recovery after surgery(ERAS) applied to stage I bilateral knee arthroplasty in patients with severe knee osteoarthritis.Methods The clinical data of 50 patients with bilateral severe knee osteoarthritis who had undergone stage I bilateral knee arthroplasty were retrospectively analyzed,and the patients were divided into ERAS group(26 cases) and control group(24 cases) according to the perioperative management methods.Postoperative Visual Analogue Scale(VAS) scores,Hospital for Special Surgery(HSS) knee scores,range of motion(ROM),incidence rate of postoperative complications,postoperative hospital stay and patient′s satisfaction were compared between the two groups.Results The postoperative knee VAS score was lower and the postoperative HSS score and ROM were higher in the ERAS group than those in the control group(all P<0.05),and the knee VAS score,HSS score and ROM all changed with time in both groups(all P<0.05),but there was no interaction between group and time(all P>0.05).In the ERAS group,the postoperative hospital stay was shorter,patients′satisfaction was higher,and the incidence rates of poor postoperative wound healing,deep venous thrombosis and urinary tract infections were lower than those in the control group(all P<0.05).Conclusion ERAS applied to stage I bilateral knee arthroplasty can promote early-stage recovery,reduce the duration of feeling pain and hospital stay,and improve the satisfaction of patients.