全髋关节置换术后快速康复的研究进展  

Research Progress of Fast Track Rehabilitation after Total Hip Arthroplasty

作　　者：吴乾[1] 郝跃峰[2] 刘毅[2] 杨卫新 管骏涛 袁振 WU Qian;HAO Yuefeng;LIU Yi;YANG Weixin;GUAN Juntao;YUAN Zhen(Medical College of Scoochow University,Suzhou 215123,China;Center of Sports Medicine and Rehabilitation,Suzhou Municipal Hospital,Suzhou 215123,China)

机构地区：[1]苏州大学医学部,江苏苏州215123 [2]苏州市立医院运动医学与康复中心,江苏苏州215123

出　　处：《医学综述》2018年第15期3023-3028,共6页Medical Recapitulate

摘　　要：全髋关节置换术因疗效好,能显著改善术后功能并降低术后病死率的优点而被广泛应用于临床,但其创伤较大,需做好康复护理。近年来,快速康复的理念在外科发展迅速,不仅强调术式的创新,还对围术期管理提出了更高的要求。术前充分评估合并症,严格控制适应证;同时做好术前谈话,帮助患者理性看待疾病。术中预防性使用抗生素并根据具体情况选择麻醉方式;联合应用氨甲环酸以减少出血,还可采用自体输血降低输血率。术后除合理镇痛外,还应尽早进行功能锻炼并辅以理疗。未来,应规范宣教流程,优化输血及镇痛,管理术后锻炼,以促进患者早期康复。Total hip arthroplasty is widely applied in clinic due to its good efficacy,which can significantly improve postoperative function and reduce postoperative mortality. However,it is more traumatic and needs better rehabilitative nursing. In recent years,the concept of rapid rehabilitation has been developing rapidly in surgery,which not only emphasizes the innovation of operation,but also puts forward higher requirements for perioperative management. Before operation,full evaluation of the complications and strict control of the indications should be done. At the same time,preoperative conversation should be made to help the patients treat the disease rationally. Intraoperative prophylactic use of antibiotics and selection of anesthetic methods according to specific conditions; combined use of methicyclic acid to reduce bleeding and to reduce the rate of blood transfusion by autologous blood transfusion are intraoperative management methods. Besides reasonable posto-perative analgesia,functional exercise should be done as soon as possible,supplemented by physical therapy after surgery. In the future,we should standardize the process of propaganda and education,optimize the management of blood transfusion and analgesia,manage postoperative exercisement,so as to promote early rehabilitation of the patients.

关 键 词：全髋关节置换术 髋部骨折 快速康复 老年 

分 类 号：R687.4[医药卫生—骨科学]