Liao Xinli, Xu Xin
Orthopedics, Huzhou Central Hospital & Affiliated Central Hospital Huzhou University Huzhou 313000, China.
Am J Transl Res. 2022 May 15;14(5):3154-3163. eCollection 2022.
To investigate the nursing effect of cold therapy combined with enhanced recovery after surgery (ERAS) in patients undergoing total knee arthroplasty (TKA).
Eighty patients with knee osteoarthritis who underwent TKA in our hospital from August 2020 to January 2021 were enrolled in this study, and they were divided into a control group (n=40) and a study group (n=40) according to the nursing procedures. The time and cost of rehabilitation, pain level, recovery of knee function, incidence of postoperative complications, self-care ability, quality of life, and nursing satisfaction were compared between the two groups.
The time of rehabilitation and time to out-of-bed activities in the study group were significantly shorter than those in the control group ( < 0.05), and the cost of rehabilitation in the study group was significantly lower than that in the control group ( < 0.05). There was no significant difference in preoperative visual analogue scale (VAS) scores (at rest, during exercise) between the two groups ( > 0.05). These scores in the study group were significantly lower than those in the control group at 6 h, 24 h, 48 h, and 72 h postoperatively ( < 0.05). The preoperative Hospital for Special Surgery (HSS), range of motion (ROM) and Barthel scores did not differ significantly between the two groups ( > 0.05). The postoperative ROM and Barthel scores were decreased to the lowest at 3 d postoperatively and gradually increased with time, and the HSS, ROM and Barthel scores in the study group were significantly higher than those in the control group ( < 0.05). The incidence of postoperative complications in the study group was significantly lower than those in the control group, and overall nursing satisfaction in the study group was significantly higher than those in the control group ( < 0.05). After discharge, the SF-36 scores of patients in both groups were higher than those before surgery, and the SF-36 scores in the study group were significantly higher than those in the control group ( < 0.05).
The cold therapy combined with ERAS for patients undergoing TKA can improve the postoperative swelling and pain of the affected limb, inspire patients' autonomy in postoperative rehabilitation training, shorten the time to out-of-bed activity, prevent patients from developing venous thrombosis, promote recovery of knee function, and improve patients' postoperative self-care ability and quality of life.
探讨冷疗联合加速康复外科（ERAS）在全膝关节置换术（TKA）患者中的护理效果。
选取2020年8月至2021年1月在我院行TKA的80例膝骨关节炎患者纳入本研究，根据护理程序将其分为对照组（n = 40）和研究组（n = 40）。比较两组患者的康复时间、康复费用、疼痛程度、膝关节功能恢复情况、术后并发症发生率、自我护理能力、生活质量及护理满意度。
研究组的康复时间和下床活动时间明显短于对照组（P < 0.05），研究组的康复费用明显低于对照组（P < 0.05）。两组术前视觉模拟评分法（VAS）（静息时、运动时）评分无显著差异（P > 0.05）。术后6 h、24 h、48 h和72 h时，研究组的这些评分明显低于对照组（P < 0.05）。两组术前特种外科医院（HSS）评分、关节活动度（ROM）和Barthel评分无显著差异（P > 0.05）。术后ROM和Barthel评分在术后3 d降至最低，随后随时间逐渐升高，研究组的HSS、ROM和Barthel评分明显高于对照组（P < 0.05）。研究组术后并发症发生率明显低于对照组，研究组的整体护理满意度明显高于对照组（P < 0.05）。出院后，两组患者的SF - 36评分均高于术前，且研究组的SF - 36评分明显高于对照组（P < 0.05）。
冷疗联合ERAS应用于TKA患者可改善患肢术后肿胀和疼痛，激发患者术后康复训练的自主性，缩短下床活动时间，预防患者发生静脉血栓形成，促进膝关节功能恢复，提高患者术后自我护理能力和生活质量。
