快速康复理念下全膝关节置换患者早期下床活动的效果研究  

The effectiveness of early ambulation in patients after total knee arthroplasty, based on the concept of fast track surgery

作　　者：林妙君[1] 温国仪[1] 周云飞 黄星球[1] 廖绪强[1] LIN Miao-jun;WEN Guo-yi;ZHOU Yun-fei;HUANG Xing-qiu;LIAO Xu-qiang(Department of Minimally invasive surgery of spine and joint,The First People's Hospital of Foshan,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市第一人民医院脊柱关节微创外科

出　　处：《广东医学》2019年第12期1719-1722,共4页Guangdong Medical Journal

基　　金：佛山市自筹经费类科技计划项目(编号:2018AB003141)

摘　　要：目的探讨快速康复理念下全膝关节置换术后患者实施早期下床活动的应用价值。方法选取100例行单侧全膝关节置换的患者,按入院时间分为观察组(53例)和对照组(47例)。观察组应用快速康复外科围手术期护理理念,术后6 h开始医护共同评估病情并实施早期下床活动;对照组采取常规围手术期护理方案,术后第1~3天下床活动。两组患者均由固定医生与专科康复护士进行资料收集。比较两组患者术后引流量、首次排尿排便时间、手术前后AKSS评分值。结果观察组患者术后引流量与对照组差异无统计学意义,观察组患者术后首次排尿排便时间明显早于对照组,手术前后AKSS评分值提示观察组膝关节功能恢复优于对照组。结论快速康复理念下医护合作实施全膝关节置换患者早期下床活动可以加快术后恢复,提高患者的术后膝关节功能,有较高的临床推广应用价值。Objective To investigate the effectiveness of applying early ambulation to enhance recovery after surgery in total knee arthroplasty(TKA). Methods 100 patients who underwent unilateral total knee arthroplasty were divided into experimental group(n=53) and control group(n=47) according to admission time. The patients in observation group received the nursing which was combined with rapid recovery concept in the perioperative period. They were required to ambulate in 6 hours after surgery with doctor-nurse collaboration.The patients in control group received routine nursing and were required to ambulate in 1-3 days after surgery. The first average urination and defecating time after operation, drainage flow and the American Knee Society Score(AKSS) were compared between two groups.Results The first average urination and defecating time after operation were significantly less than the control group(P<0.05) and the AKSS was significantly higher than the control group(P<0.05). However, drainage flow had no statistical significance between two groups(P>0.05). Conclusion Under the concept of fast track surgery, doctor-nurse cooperation and early ambulation in patients after total knee arthroplasty can accelerate the postoperative recovery and improve the postoperative knee joint function of patients, which is of high clinical application value.

关 键 词：快速康复理念 膝关节置换 早期下床活动 应用价值 

分 类 号：R473[医药卫生—护理学] R619[医药卫生—临床医学]