Larsen Kristian, Sørensen Ole Gade, Hansen Torben B, Thomsen Per B, Søballe Kjeld
The Musculoskeletal Research Unit, Department of Orthopedics, Holstebro Regional Hospital, Holstebro, Denmark.
Acta Orthop. 2008 Apr;79(2):149-59. doi: 10.1080/17453670710014923.
Approximately 12,000 hip and knee replacements were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, but there is conflicting evidence regarding the effect. We therefore performed an efficacy study of an accelerated perioperative care and rehabilitation intervention in patients receiving primary total hip replacement, and both total and unicompartmental knee replacement.
A randomized clinical trial was undertaken in which 87 patients were randomized to either a control group receiving the current perioperative procedure, or an intervention group receiving a new accelerated perioperative care and rehabilitation procedure. Outcome measures were length of stay (LOS) in hospital, and gain in quality of life (QOL) using EQ-5D from baseline to 3-month follow-up.
Mean LOS was reduced (p < 0.001) from 8 days (95% CI: 7.1-8.4) in the control group to 5 days (95% CI: 4.2-5.6) in the intervention group. This was accompanied by a greater gain in QOL of 0.08 (95% CI: 0.004-0.16) in the intervention group (p = 0.03).
An accelerated perioperative care and rehabilitation intervention in patients undergoing primary total hip replacement, and total or unicompartmental knee replacement is indeed effective-and of advantage to both the hospital and the patient.
2005年丹麦大约进行了12000例髋关节和膝关节置换手术。目前已实施了加速围手术期干预措施，但关于其效果的证据存在矛盾。因此，我们对接受初次全髋关节置换、全膝关节置换和单髁膝关节置换的患者进行了一项加速围手术期护理与康复干预的疗效研究。
进行了一项随机临床试验，87例患者被随机分为两组，一组为接受当前围手术期程序的对照组，另一组为接受新的加速围手术期护理与康复程序的干预组。观察指标为住院时间（LOS），以及使用EQ-5D从基线到3个月随访时的生活质量（QOL）改善情况。
对照组的平均住院时间从8天（95%CI：7.1 - 8.4）降至干预组的5天（95%CI：4.2 - 5.6）（p < 0.001）。与此同时，干预组的生活质量改善幅度更大，为0.08（95%CI：0.004 - 0.16）（p = 0.03）。
对接受初次全髋关节置换、全膝关节置换或单髁膝关节置换的患者进行加速围手术期护理与康复干预确实有效，且对医院和患者都有利。
