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全关节置换术患者术后的加速康复:一项回顾性研究。

Enhanced Recovery after Surgery in patients undergoing total joint arthroplasty: A retrospective study.

作者信息

Zhao Xizhen, Chen Lingmin, Huang Feiri, Huang Zhihong, Zhou Huijie

机构信息

Xizhen Zhao Department of Orthopedics, The Third Affiliated Hospital of Shanghai University (Wenzhou People's Hospital), Wenzhou 325000, Zhejiang Province, P.R. China.

Lingmin Chen Department of Urology Surgery, The Third Affiliated Hospital of Shanghai University (Wenzhou People's Hospital), Wenzhou 325000, Zhejiang Province, P.R. China.

出版信息

Pak J Med Sci. 2023 May-Jun;39(3):644-649. doi: 10.12669/pjms.39.3.7169.

Abstract

OBJECTIVE

Enhanced Recovery after Surgery (ERAS) protocol has been developed and practiced for various surgical procedures to improve outcomes in the postoperative period. We hereby present our experience of ERAS for a large cohort of patients undergoing total joint arthroplasty (TJA).

METHODS

We implemented the ERAS program at The Third Affiliated Hospital of Shanghai University from January 2020 and retrospectively compared outcomes of patients undergoing total knee or hip arthroplasty before and after the implementation of the program. ERAS protocol consisted of the use of patient education, blood management, multimodal analgesia, antiemetics, shorter fasting time, no patient-controlled analgesia, early physical therapy, and reduced use of catheters and drains.

RESULTS

There were 94 patients in the study group (ERAS) and 113 patients in the control group (non-ERAS). We noted a statistically significant reduction in the incidence of postoperative nausea/vomiting, lowered pain scores, reduced length of hospital stay and better functional outcomes with both total knee and hip arthroplasties in our study cohort.

CONCLUSION

ERAS protocol can bae effectively implemented for patients undergoing TJA. The use of ERAS leads to better postoperative outcomes and shortened hospital stay.

摘要

目的

为改善术后预后,已针对各种外科手术制定并实施了加速康复外科(ERAS)方案。在此,我们介绍我们在一大批接受全关节置换术(TJA)的患者中应用ERAS的经验。

方法

我们于2020年1月在上海大学附属第三医院实施了ERAS项目,并对该项目实施前后接受全膝关节或髋关节置换术的患者的预后进行了回顾性比较。ERAS方案包括患者教育、血液管理、多模式镇痛、使用止吐药、缩短禁食时间、不使用患者自控镇痛、早期物理治疗以及减少导管和引流管的使用。

结果

研究组(ERAS)有94例患者,对照组(非ERAS)有113例患者。我们注意到,在我们的研究队列中,全膝关节和髋关节置换术的术后恶心/呕吐发生率显著降低、疼痛评分降低、住院时间缩短且功能预后更好。

结论

ERAS方案可有效地应用于接受TJA的患者。使用ERAS可带来更好的术后预后并缩短住院时间。

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