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2天内完成全膝关节和髋关节置换术:丹麦快速康复模式

[Total knee and hip arthroplasty within 2 days : The Danish Fast-Track Model].

作者信息

Jung Kai-Dieter, Husted Henrik, Kristensen Billy B

机构信息

Abteilung für Ambulante Chirurgie, Hvidovre Hospital, Kettegård Alle 30, 2650, Hvidovre, Dänemark.

Abteilung für Orthopaedie, Hvidovre Hospital, Kettegård Alle 30, 2650, Hvidovre, Dänemark.

出版信息

Orthopade. 2020 Mar;49(3):218-225. doi: 10.1007/s00132-019-03796-5.

Abstract

BACKGROUND

Patients in Denmark undergoing total knee or hip replacement are routinely discharged within 2 days of surgery. A critical examination of traditional treatment methods, combined with focused research, has during the last 20 years increasingly optimized the treatment course in such a way that it has become possible to radically reduce the length of stay (LOS).

BASICS OF THE FAST-TRACK MODEL: The most important elements of this Fast-Track model are described. The patient motivation and transfer of partial responsibility to the patient through intensive information, optimized operation techniques, as well as modern multi-modal pain therapy with early mobilization are key issues. The relatively small and homogenous health care system of Denmark offers good research conditions and the possibility of a fast implementation of the latest results, as well as a lump-sum based re-imbursement system without minimum stay-both factors have been favorable for the development of the Fast-Track model.

摘要

背景

在丹麦,接受全膝关节或髋关节置换手术的患者通常在术后2天内出院。在过去20年中,对传统治疗方法进行批判性审视并结合重点研究,日益优化了治疗过程,从而有可能大幅缩短住院时间(LOS)。

快速康复模式的基础

描述了这种快速康复模式的最重要要素。患者的积极性以及通过强化信息告知、优化手术技术,还有早期活动的现代多模式疼痛治疗将部分责任转移给患者是关键问题。丹麦相对小型且同质化的医疗保健系统提供了良好的研究条件以及快速应用最新成果的可能性,还有基于一次性付费的报销系统且无最短住院时间要求——这两个因素都有利于快速康复模式的发展。

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