全膝关节置换日间手术的发展现状及开展策略  

Development status and strategy of outpatient total knee arthroplasty

作　　者：康波 王晋东[2] Kang Bo;Wang Jindong(Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学,山西省太原市030001 [2]山西医科大学第二医院,山西省太原市030001

出　　处：《中国组织工程研究》2021年第27期4408-4414,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着全膝关节置换技术不断发展以及加速康复外科理念在全膝关节置换中的应用,现在全膝关节置换患者创伤更小、出血更少、恢复更快、住院周期明显缩短,部分患者甚至可以在手术当天出院。在国外,很多全膝关节置换日间手术已经在日间手术中心成功开展;在国内,开展全膝关节置换日间手术尚处于探索阶段,相关文献报道相对较少。目的:主要通过查阅全膝关节置换日间手术相关文献,对其发展状况及开展策略作一综述,以期能为国内开展全膝关节置换日间手术提供部分参考。方法:利用计算机检索CNKI、万方、PubMed及Web of Science数据库自建库至2020年9月有关全膝关节置换日间手术的文献,中英文检索词为“全膝关节置换,关节置换,日间手术;total knee arthroplasty,total joint arthroplasty,arthroplasty,replacement,knee,outpatient,same-day discharge,ambulatory surgical procedures”。仔细阅读相关文献,最终共纳入61篇文献进行结果分析。结果与结论:①国外全膝关节置换日间手术的开展比例逐年增加,对严格筛选的患者实施全膝关节置换日间手术是相对安全的,术后并发症和再入院发生率低;②目前一些国内三甲医院已经实现一部分患者术后第1天出院,甚至部分患者可以手术当天出院;③全膝关节置换日间手术在国内开展具备一定条件。BACKGROUND:With the development of total knee arthroplasty and the application of the concept of enhanced recovery after surgery in total knee arthroplasty,patients with total knee arthroplasty now have lesser trauma,fewer bleeding,faster recovery and effectively shorten length of stay.Some patients can even be discharged on the same day of surgery.Outside China,many hospitals have carried out outpatient total knee arthroplasty in the Ambulatory Surgery Center.In China,the outpatient total knee arthroplasty is still in the exploratory stage,and there are relatively few reports about it.OBJECTIVE:To describe the development status and strategies of outpatient total knee arthroplasty by referring to the relevant literature of outpatient total knee arthroplasty,so as to provide some ideas for the implementation of outpatient total knee arthroplasty in China.METHODS:These articles of outpatient total knee arthroplasty from the inception of the database to September 2020 were retrieved from CNKI,Wanfang,PubMed and Web of Science databases by computer.The search words in Chinese and English were“total knee arthroplasty”,“total joint arthroplasty”,“arthroplasty,replacement,knee”,“outpatient”,“same-day discharge”,“ambulatory surgical procedures”.Finally,61 articles were included to analyze the results.RESULTS AND CONCLUSION:(1)The proportion of outpatient total knee arthroplasty in foreign countries was rapidly growing each year.It is relatively safe to perform outpatient total knee arthroplasty on strictly selected patients and the incidence of postoperative complications and readmission was low.(2)At present,some domestic third-level grade-A hospitals have achieved that some patients are discharged on the first day after surgery,and even some patients can be discharged on the same day of surgery.(3)This means that there are certain conditions for carrying out outpatient total knee arthroplasty in China.

关 键 词：膝关节 全膝关节置换 日间手术 日间手术中心 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]