全流程优化日间手术方案在关节镜下肩袖修补术中的应用效果评价  

Effect of whole-process optimization of day surgery in rotator cuff repair under arthroscopy

作　　者：郑军[1,2] 费文勇 朱长仁[4] 胡洋洋[5] ZHENG Jun;FEI Wenyong;ZHU Changren;HU Yangyang(Day Operation Ward,North Jiangsu People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225001;North Jiangsu People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225001;Department of Sports Medicine,North Jiangsu People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225001;Department of Pathology,Nursing College of Yangzhou University,Yangzhou,Jiangsu,225001;Clinical Medicine College of Yangzhou University,Yangzhou,Jiangsu,225001)

机构地区：[1]江苏省苏北人民医院日间手术病房,江苏扬州225001 [2]扬州大学护理学院,江苏扬州225001 [3]江苏省苏北人民医院运动医学科,江苏扬州225001 [4]江苏省苏北人民医院病理科,江苏扬州225001 [5]扬州大学临床医学院,江苏扬州225001

出　　处：《实用临床医药杂志》2023年第12期63-68,共6页Journal of Clinical Medicine in Practice

基　　金：国家骨科与运动康复临床医学研究中心创新基金资助项目(2021-NCRC-CXJJ-PY-07);江苏省卫生健康委员会基金资助项目(M2021042)。

摘　　要：目的 观察全流程优化日间手术方案在关节镜下肩袖修补术中的应用效果。方法 选取140例关节镜肩袖修补术患者作为研究对象,随机分为实验组和对照组,每组70例。实验组采用全流程优化日间手术方案,对照组采用常规住院手术方案,比较2组患者平均住院时间、住院费用、术后并发症、肩关节康复效果等。结果 实验组平均住院时间、术前待床时间均短于对照组,差异有统计学意义(P<0.05);实验组住院总费用和住院治疗费用均低于对照组,差异有统计学意义(P<0.05)。实验组术后并发症总发生率(2.86%)低于对照组(4.29%),术后不良反应总发生率(15.71%)高于对照组(12.86%),但差异均无统计学意义(P>0.05)。实验组术后1个月时肩关节前屈、外展、中立位外旋活动度大于对照组,术后3个月时肩关节前屈、外展、中立位外旋、体侧内旋活动度均大于对照组,术后6个月时体侧内旋活动度大于对照组,差异均有统计学意义(P<0.05);2组术后6个月时肩关节前屈、外展、中立位外旋活动度和Constant评分、ASES评分差异无统计学意义(P>0.05)。实验组患者术后1、3、6个月时疼痛评分均低于对照组,差异有统计学意义(P<0.05)。实验组患者教育知晓率、满意度依次为92.86%、97.14%,分别高于对照组的84.29%、90.00%,差异有统计学意义(P<0.05)。结论 整合多学科医疗护理资源对关节镜下肩袖修补术患者实施全流程优化日间手术管理,可有效缩短患者住院时间,减少住院费用,加速患者康复。Objective To observe the application effect of whole-process optimization of day surgery in rotator cuff repair under arthroscopy.Methods A total of 140 patients with arthroscopic rotator cuff repair were selected as study objects,and were randomly divided into experimental group(day surgery of whole-process optimization,n=70)and control group(routine inpatient surgical protocol,n=70).The average hospitalization days,hospitalization expenses,postoperative complication,shoulder joint rehabilitation effect of the two groups were compared.Results The average hospital stay and preoperative bed stay time of the experimental group were shorter than those of the control group(P<0.05);the total hospitalization cost and hospitalization cost of the experimental group were lower than those of the control group(P<0.05);the total incidence of postoperative complications in the experimental group was lower than that in the control group,and the total incidence of postoperative adverse reactions was higher than that in the control group,but the differences were not statistically significant(2.86%versus 4.29%,15.71%versus 12.86%,respectively,P>0.05).At 1 month,the experimental group had larger forward flexion,abduction,and neutral external rotation motion in the observation group compared to those in the control group(P<0.05);at 3 months,the experimental group had larger forward flexion,abduction,neutral external rotation motion and lateral internal rotation in the observation group compared to those in the control group(P<0.05);at 6 months after operation,forward flexion,abduction,and neutral external rotation motion,Constant score and ASES score in the experimental group showed no significant differences between two groups(P>0.05).The pain scores of the experimental group were lower than those of the control group at 1 month,3 and 6 months after operation(P<0.05).The educational awareness rate and satisfaction rate of the experimental group were 92.86%and 97.14%,respectively,which were higher than 84.29%and 90.00%of the contro

关 键 词：加速康复外科 日间手术 关节镜 肩袖损伤 全周期 全流程优化 

分 类 号：R685[医药卫生—骨科学] R473.6[医药卫生—外科学]