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围手术期快速康复外科理念对全髋关节置换术患者躯体和心理康复的影响:一项前瞻性队列研究 348 例患者。

Impacts of the perioperative fast track surgery concept on the physical and psychological rehabilitation of total hip arthroplasty: A prospective cohort study of 348 patients.

机构信息

Department of Orthopaedics, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

Department of Endocrinology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

出版信息

Medicine (Baltimore). 2021 Aug 13;100(32):e26869. doi: 10.1097/MD.0000000000026869.

Abstract

Studies have shown that rapid rehabilitation surgery has a positive effect on recovery after major orthopedic surgery. However, very few studies have examined the impact of fast track surgery on physical and psychological rehabilitation in patients who have undergone total hip replacement.This study aimed to investigate the value of the rapid rehabilitation surgical model for patients undergoing total hip arthroplasty during the perioperative period.We conducted a prospective cohort study that included patients who underwent total hip arthroplasty at our hospital from January 2015 to December 2018. We divided the patients into 2 groups - the rapid rehabilitation group and the conventional rehabilitation group - and compared their length of hospital stay, time to off-bed activity, pain score, Self-Rating Anxiety Scale scores, Self-Rating Depression Scale scores, complication rate, and rate of satisfaction during hospitalization.A total of 348 patients were included in the study. Of these, 180 received rapid rehabilitation nursing and 168 patients received conventional nursing. Compared with the patients in the conventional rehabilitation group, those in the rapid rehabilitation group had shorter hospital stays (11.5 ± 1.2 day vs 15.5 ± 2.3 day, P = .021), resumed off-bed activities sooner (20.5 ± 3.4 hours vs 61.8 ± 4.7 hours, P = .001, had less postoperative pain (4.0 ± 1.2 vs 6.5 ± 1.1, P < .001), and lower anxiety and depression scores (anxiety score: 24.4 ± 2.1 vs 47.9 ± 2.9; depression score: 25.8 ± 1.8 vs 43.7 ± 1.7, P < .001).The application of rapid rehabilitation surgery in total hip arthroplasty can accelerate patients' postoperative recovery, relieve anxiety and depression, and increase the patient's satisfaction with the treatment.

摘要

研究表明,快速康复外科对大骨科手术后的恢复有积极影响。然而,很少有研究探讨快速通道手术对全髋关节置换术后患者的身体和心理康复的影响。本研究旨在探讨快速康复外科模式在全髋关节置换术围手术期患者中的应用价值。

我们进行了一项前瞻性队列研究,纳入了 2015 年 1 月至 2018 年 12 月在我院行全髋关节置换术的患者。将患者分为快速康复组和常规康复组,比较两组患者的住院时间、下床活动时间、疼痛评分、焦虑自评量表评分、抑郁自评量表评分、并发症发生率和住院期间满意度。

共纳入 348 例患者,其中 180 例行快速康复护理,168 例行常规护理。与常规康复组患者相比,快速康复组患者的住院时间更短(11.5±1.2 天 vs 15.5±2.3 天,P=.021),下床活动时间更早(20.5±3.4 小时 vs 61.8±4.7 小时,P=.001),术后疼痛较轻(4.0±1.2 分 vs 6.5±1.1 分,P<.001),焦虑和抑郁评分较低(焦虑评分:24.4±2.1 分 vs 47.9±2.9 分;抑郁评分:25.8±1.8 分 vs 43.7±1.7 分,P<.001)。

快速康复外科在全髋关节置换术中的应用可以加快患者术后恢复,缓解焦虑和抑郁,提高患者对治疗的满意度。

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