加速康复外科理念在膝关节假体置换围术期的应用及疗效探讨  

Perioperative application and effect of enhanced recovery after surgery in knee joint prosthesis replacement

作　　者：杨丽梅[1] 马晓燕 张生英 安东 王春丽 马秀才 Yang Limei;Ma Xiaoyan;Zhang Shengyin;An Dong;Wang Chunli;Ma Xiucai(Department of Outpatient,Gansu Province Hospital,Lanzhou 730000,China;Department of Bone and Soft Tissue Tumors,Gansu Province Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院门诊部,兰州730000 [2]甘肃省人民医院骨与软组织肿瘤科,兰州730000

出　　处：《中华转移性肿瘤杂志》2023年第1期41-45,共5页Chinese Journal of Metastatic Cancer

基　　金：中国红十字基金会项目(XM_HR_HARVEST_2021_05)。

摘　　要：目的观察加速康复外科(ERAS)理念在膝关节肿瘤假体置换术患者的围手术期的疗效。方法将2018—2021年间甘肃省人民医院收治的准备行膝关节肿瘤假体置换术的36例膝关节周围恶性肿瘤患者均分为ERAS组和常规组。ERAS组围手术期采用加速康复理念对患者进行治疗,常规组采用传统方法治疗。术后对视觉模拟评分法(VAS)、手术出血及输血量、膝关节周围肿瘤术后功能评分(MSTS)、住院时间及术后患者满意度进行评估统计。结果ERAS组与对照组术后14 d VAS评分为(0.86±0.55)与(2.33±0.87)(P=0.023),术后1年MSTS评分为(26.26±2.050)与(24.16±1.82)(P=0.046),住院时间为(9.26±1.33)d与(11.32d±2.12)d(P=0.021),术后患者满意度为(98.36±1.55)%与(93.33±4.81)%(P=0.026)。结论ERAS理念在膝关节周围骨恶性肿瘤围术期中能有效减轻患者术后疼痛、加速其康复进度,具有较高临床应用价值。Objective To observe the perioperative efficacy of enhanced recovery after surgery(ERAS)in patients undergoing knee tumor prosthesis replacement.Methods Thirty-six patients with osteosarcoma around the knee undergoing knee tumor prosthesis replacement in Gansu Provincial People's hospital from January 2018 to August 2021 were divided equally into the ERAS group and the conventional group.Patients in the ERAS group were treated with ERAS during perioperative period,while patients in the conventional group were treated with conventional methods.The postoperative visual analogue scale(VAS),surgical bleeding and blood transfusion volume,knee function score(MSTS),length of hospital stay and postoperative patient satisfaction were evaluated.Results Compared with the conventional group,the postoperative VAS scores(0.86±0.55 in the ERAS group vs.2.33±0.87 in the conventional group,P=0.023)and the MSTS scores at 1 year after operation(26.26±2.05 in the ERAS group vs.24.16±1.82) in the conventional group,P=0.046 were significantly improved in the ERAS group,the length of hospital stay(9.26d±1.33d in the ERAS group vs.11.32d±2.12d in the conventional group,P=0.021)was shortened in the ERAS group,and the postoperative patient satisfaction(98.36±1.55 in the ERAS group vs.93.33±4.81 in the conventional group,P=0.026)was increased in the ERAS group.Conclusions ERAS can effectively reduce postoperative pain and accelerate the rehabilitation process during perioperative period in patients with bone malignant tumor around the knee joint,and has good clinical application value.

关 键 词：加速康复外科 肿瘤假体置换 骨肉瘤 围手术期 

分 类 号：R687.4[医药卫生—骨科学]