高龄患者髋关节置换的ERAS路径与传统路径的临床疗效对比  

Clinical comparisons of ERAS and routine interventions for elderly hip arthroplasty

作　　者：李建锋[1] 李强[1] 黄欢[1] 张希峰[1] 严建锋[1] 蔡莉丹 LI Jianfeng;LI Qiang;HUANG Huan;ZHANG Xifeng;YAN Jianfeng;CAI Lidan(Joint Surgery Department,Changshu No.2 People's Hospital,Changshu 215500,China)

机构地区：[1]常熟市第二人民医院关节外科,江苏省常熟市215500

出　　处：《组织工程与重建外科》2022年第2期154-156,共3页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：常熟市卫生健康委员会科技计划项目(csws201904)。

摘　　要：目的探讨加速康复外科(ERAS)路径与传统路径在高龄患者髋关节置换术中的应用效果。方法2019年1月至2020年7月,96例择期行髋关节置换术治疗的高龄患者,随机分为对照组和研究组,每组各48例。其中,对照组围手术期实施传统路径干预,而研究组实施ERAS路径干预,对比两种路径临床干预效果。结果研究组术中失血量少于对照组,切口愈合时间和住院总时长短于对照组,差异显著(P<0.05);但两组手术时长无明显差异(P>0.05)。研究组术前和术后6个月的疼痛评分和髋关节功能评分与对照组相比均无明显差异(P>0.05);但其术后1个月和术后3个月的疼痛评分低于对照组,髋关节功能评分高于对照组,差异显著(P<0.05)。研究组并发症发生率6.25%,低于对照组29.17%,差异显著(P<0.05)。结论与传统路径相比,ERAS路径更有利于减轻高龄髋关节置换患者的疼痛症状,在减少术后并发症的同时可有效促进患者早期康复,临床应用优势更胜一筹。Objective To explore the effects of ERAS(enhanced recovery after surgery)and routine interventions for elderly hip arthroplasty.Methods From January 2019 to July 2020,96 elderly patients who underwent elective hip replacement were randomly divided into control group and study group,48 cases in each group.The control group received the routine interventions,while the study group received ERAS.Intervention outcomes were compared between the 2 groups.Results The intraoperative blood loss in the study group was less than that in the control group,and the incision healing time and total length of hospitalization were less than that in the control group,with significant differences(P<0.05).However,there was no significant difference in operation duration between the two groups(P>0.05).There were no significant differences in pain score and hip function score between the study group and the control group before and 6 months after surgery(P>0.05).However,the pain score at 1 month and 3 months after surgery was lower than that of the control group,and the hip function score was higher than that of the control group,with significant differences(P<0.05).The complication rate in the study group was 6.25%,which was significantly lower than that in the control group(29.17%,P<0.05).Conclusion ERAS can better reduce the pain symptoms and surgical complications,and promote the patient's fast rehabilitation.It is worthy of clinical application.

关 键 词：加速康复外科 传统路径 髋关节置换术 高龄患者 并发症 

分 类 号：R687.4[医药卫生—骨科学]