老年人全髋关节置换围手术期快速康复护理  

Enhanced recovery after surgery and nursing care during perioperative period of total hip arthroplasty in elderly

作　　者：白伟侠 卢连君[1] 田晓霞 曹彭凯 刘磊[1] BAI Wei-xia;LU Lian-jun;TIAN Xiao-xia;CAO Peng-kai;LIU Lei(The Third Hospital,Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院,河北石家庄050051

出　　处：《中国矫形外科杂志》2020年第11期928-932,共5页Orthopedic Journal of China

基　　金：河北省医学科学研究重点课题计划项目(编号:20180419)。

摘　　要：[目的]比较老年全髋关节置换术(total hip arthroplasty,THA)快速康复护理与传统康复护理的早期效果。[方法]2019年1月~2019年4月在本院行全髋关节置换术的70例患者,随机分为两组,每组35例。围手术期快速康复组采用快速康复方法与护理,传统康复组采用传统康复方法和相应护理。比较两组患者术后2周,1个月和6个月时Harris评分、早期并发症和患者满意率。[结果]随术后时间推移两组患者的Harris评分均显著增加(P<0.05)。术前两组间Harris评分的差异无统计学意义(P>0.05),但术后2周、术后1个月、术后6个月时,快速康复组患者的Harris评分均显著高于传统康复组(P<0.05)。围手术期快速康复组出现下肢静脉血栓2例;而传统康复组出现下肢静脉血栓5例,低钠血症1例,两组间并发症发生率的差异无统计学意义(P>0.05)。出院时,快速康复组患者满意率为94.43%,而传统康复组为88.57%;快速康复组患者家属满意率为97.14%,而传统康复组为91.43%;两组间差异无统计学意义(P>0.05)。[结论]对老年患者THA围手术期采用快速康复护理的早期效果优于传统康复护理。[Objective]To compare the early outcome of enhanced recovery after surgery(ERAS)and nursing care versus traditional rehabilitation(TR)and nursing care during perioperative period of total hip arthroplasty(THA)in the elderly(THA).[Methods]Between January 2019 and April 2019,a total of 70 elderly patients who were undergoing THA were included in this study,and divided into two groups randomly.In term of perioperative rehabilitation and nursing care given,the patients in the ERAS group received enhanced recovery after surgery and corresponding nursing care program,while those in the TR group had traditional rehabilitation and related nursing care.The Harris scores before operation and at 2 weeks,1 and 6 months postoperatively,as well as complications and patient’s satisfaction were compared between the two groups.[Results]As time went the Harris scores significantly increased in both groups(P<0.05).Although no a statistically significant difference in Harris score preoperatively was noticed between the two groups(P>0.05),the ERAS group was marked significantly higher Harris scores than the TR group at 2 weeks,1 and 6 months postoperatively(P<0.05).In term of complications,the ERAS group had venous thrombosis of low extremity in 2 patients only,whereas the TR group was found venous thrombosis of low extremity in 5 patients and hyponatremia in 1 patient,despite of no a statistical difference between the two groups(P>0.05).At discharge from hospital,the patients’satisfaction was of 94.43%in the ERAS group,whereas 88.57%in the TR group,in addition,the satisfaction of the patient’s relative was of 97.14%in the ERAS group,while 91.43%in the TR group,regardless of no statistical differences between them(P>0.05).[Conclusion]The enhanced recovery after surgery and nursing care is superior to the traditional rehabilitation and nursing care in term of early outcome during the perioperative period of THA in the elderly.

关 键 词：老年人 全髋关节置换 快速康复 传统康复 护理 

分 类 号：R687.4[医药卫生—骨科学]