肘关节骨折术后康复中ERAS的应用及对患者肘关节功能恢复的影响  

Application of ERAS in postoperative rehabilitation of elbow fracture and its effect on elbow function recovery

作　　者：王翰 崔海峰 Wang Han;Cui Haifeng

机构地区：[1]中国人民解放军联勤保障部队第964医院骨科,130000

出　　处：《中国疗养医学》2021年第8期847-850,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨将加速康复(ERAS)理念运用于肘关节骨折患者术后康复过程中的效果及对其肘关节功能恢复的影响。方法选取2018年1月至2019年1月联勤保障部队第964医院骨科收治的60例肘关节骨折患者,按照随机数字表分为对照组和观察组各30例,对照组患者给予常规康复干预;观察组患者给予ERAS理念干预;观察两组患者肘关节功能康复效果及活动度、各时间点的焦虑与疼痛状况以及并发症发生情况等。结果干预后,两组患者肘关节功能康复效果及肘关节活动度(ROM)均获得改善,且观察组明显优于对照组[90.00%VS 66.67%,(135.62±4.26)°VS(100.58±5.23)°,χ^(2)=4.811,t=28.452,P<0.05];观察组术后1 d、3 d及出院时的焦虑自评量表(SAS)评分均显著优于对照组[(58.78±1.23)分VS(66.51±0.12)分,(50.53±2.96)分VS(59.56±5.36)分,(48.36±3.26)分VS(55.58±1.56)分,t=34.259、8.077、10.942,P<0.001];观察组术后8 h、12 h、24 h的视觉疼痛模拟评分法(VAS)评分皆优于对照组[(5.35±0.52)分VS(5.95±0.63)分,(4.89±0.10)分VS(5.01±0.11)分,(3.12±0.24)分VS(4.95±0.17)分,t=4.023、4.421、2.570,P<0.05];观察组患者并发症总发生率为10.00%,相较对照组的56.67%低(χ2=14.700,P<0.05)。结论肘关节骨折术后患者康复过程中采取ERAS理念干预,可有利于加快肘关节功能康复速度,缓解患者不良情绪与疼痛,减少并发症,其疗效与安全性较佳。Objective To explore the effect of enhanced recovery after surgery(ERAS)concept applied to the postoperative rehabilitation of patients with elbow fracture and its influence on the functional recovery of elbow joint.Methods Sixty patients with elbow fracture admitted to the No.964 Hospital of the Joint Logistic Support Force from January 2018 to January 2019 were selected and divided into control group(n=30)and observation group(n=30)according to random number table.Patients in the control group were given routine rehabilitation intervention.Those in the observation group were given ERAS concept intervention.The rehabilitation effect and range of motion,anxiety and pain at each time point,and the incidence of complications were observed in both groups.Results After intervention,the rehabilitation effect of elbow function and range of motion(ROM)of elbow were improved in 2 groups,and the observation group was significantly better than the control group[90.00%VS 66.67%,(135.62±4.26)°VS(100.58±5.23)°,χ2=4.811,t=28.452,P<0.05];The self-rating anxiety scale(SAS)score of the observation group was significantly better than that of control group(58.78±1.23)VS(66.51±0.12),(50.53±2.96)VS(59.56±5.36),on the 1st and 3rd after surgery and at discharge[(48.36±3.26)score VS(55.58±1.56)score,t=34.259,8.077,10.942,P<0.001];Visual analogue scale(VAS)scores of the observation group at 8 h,12 h and 24 h after surgery were all better than those of the control group[(5.35±0.52)VS(5.95±0.63),(4.89±0.10)VS(5.01±0.11),(3.12±0.24)score VS(4.95±0.17)score,t=4.023,4.421,2.570,P<0.05];The total incidence of complications in observation group was 10.00%which was lower than 56.67%in control group(χ2=14.700,P<0.05).Conclusion In the rehabilitation process of patients with elbow fracture after surgery,ERAS concept intervention can help to accelerate the rehabilitation speed of elbow function,relieve patients'bad mood and pain,and reduce complications,with good efficacy and safety.

关 键 词：肘关节 骨折 加速康复理念 功能恢复 康复 

分 类 号：R473.6[医药卫生—护理学]