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快速康复膝关节置换术——现状与未来挑战

Fast-track knee arthroplasty -- status and future challenges.

作者信息

Kehlet Henrik, Thienpont Emmanuel

机构信息

Section for Surgical Pathophysiology, Rigshospitalet Copenhagen University, Denmark and The Lundbeck Centre for fast-track hip and knee replacement, Av. Hippocrate 10, 1200 Brussels, Belgium.

出版信息

Knee. 2013 Sep;20 Suppl 1:S29-33. doi: 10.1016/S0968-0160(13)70006-1.

Abstract

BACKGROUND

Fast-track programs have been developed for different surgical procedures leading to higher patient satisfaction and lower morbidity. This concept has been extended to knee arthroplasty in recent years. The purpose of this narrative review was to discuss the different aspects of fast-track knee arthroplasty.

METHOD

Both authors searched the contemporary literature on minimally invasive knee arthroplasty and review articles on fast-track surgery aiming to summarize recent developments.

RESULTS

Length of stay after knee arthroplasty is influenced by preoperative risk factors, anaesthetic and surgical techniques, pain, orthostatic intolerance, cognitive function, sleep disturbances, bleeding and anaemia and finally muscle function and rehabilitation.

CONCLUSIONS

Fast-track surgery reduces the length of stay and the morbidity after knee arthroplasty.

CLINICAL RELEVANCE

Optimisation of pre-, per- and postoperative pathway for knee arthroplasty reduces morbidity after this type of surgery and results in shorter length of stay.

摘要

背景

针对不同外科手术已开展了快速康复计划,这提高了患者满意度并降低了发病率。近年来,这一概念已扩展至膝关节置换术。本叙述性综述的目的是探讨快速康复膝关节置换术的不同方面。

方法

两位作者检索了关于微创膝关节置换术的当代文献以及关于快速康复手术的综述文章,旨在总结近期进展。

结果

膝关节置换术后的住院时间受术前危险因素、麻醉和手术技术、疼痛、体位性不耐受、认知功能、睡眠障碍、出血和贫血,以及最终的肌肉功能和康复的影响。

结论

快速康复手术可缩短膝关节置换术后的住院时间并降低发病率。

临床意义

优化膝关节置换术的术前、术中和术后流程可降低此类手术后的发病率,并缩短住院时间。

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