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基于术后加速康复(ERAS)原则的围手术期护理在全膝关节置换术患者中的应用

Application of Perioperative Nursing Based on Enhanced Recovery After Surgery (ERAS) Principles in Patients Undergoing Total Knee Arthroplasty.

作者信息

Huang Juan, Wu Guoqing, Li Xiaohong

机构信息

Department of Orthopedics, Dazhou Central Hospital, Dazhou City, Sichuan Province, 635000, People's Republic of China.

Department of Medical Insurance Management, Dazhou Central Hospital, Dazhou City, Sichuan Province, 635000, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2025 May 31;21:829-839. doi: 10.2147/TCRM.S515992. eCollection 2025.

Abstract

BACKGROUND

Enhanced Recovery After Surgery (ERAS) principles have gained widespread adoption in perioperative care to optimize recovery and reduce complications. Total knee arthroplasty (TKA) patients benefit significantly from ERAS-guided strategies, which minimize surgical stress and accelerate postoperative recovery. This study evaluates the application of perioperative nursing care based on ERAS principles and its impact on TKA patients.

METHODS

A retrospective analysis was conducted on prospectively maintained data of 312 patients who underwent TKA between January 2023 and December 2023. Of these, 158 patients received perioperative nursing care based on ERAS principles, while 154 received standard nursing care. The ERAS-based perioperative nursing protocol included preoperative education, intraoperative fluid optimization, postoperative pain management, and early mobilization strategies. Clinical data, including postoperative complications, length of hospital stay, and patient satisfaction, were collected and compared between the two groups using statistical methods.

RESULTS

Patients in the ERAS-based nursing group exhibited significantly better outcomes compared to the standard care group. Postoperative complications, such as deep vein thrombosis and infections, were reduced (4.4% vs 11.7%, P<0.05), and the average length of hospital stay was shorter (5.6 ± 1.8 days vs 8.3 ± 2.4 days, P<0.001). Patient satisfaction scores were notably higher in the ERAS group (94.3% vs 78.6%, P<0.001). Multivariate analysis identified perioperative nursing based on ERAS principles as an independent factor for improved recovery.

CONCLUSION

Perioperative nursing care guided by ERAS principles significantly improves clinical outcomes in TKA patients, reducing complications and hospital stay while enhancing patient satisfaction. This study supports the broader implementation of ERAS protocols in perioperative nursing to optimize surgical care outcomes.

摘要

背景

术后加速康复(ERAS)原则已在围手术期护理中广泛应用,以优化康复并减少并发症。全膝关节置换术(TKA)患者从ERAS指导的策略中显著获益,这些策略可将手术应激降至最低并加速术后康复。本研究评估基于ERAS原则的围手术期护理的应用及其对TKA患者的影响。

方法

对2023年1月至2023年12月期间接受TKA的312例患者的前瞻性维护数据进行回顾性分析。其中,158例患者接受基于ERAS原则的围手术期护理,154例接受标准护理。基于ERAS的围手术期护理方案包括术前教育、术中液体优化、术后疼痛管理和早期活动策略。收集两组患者的临床数据,包括术后并发症、住院时间和患者满意度,并使用统计方法进行比较。

结果

与标准护理组相比,基于ERAS护理组的患者表现出明显更好的结果。深静脉血栓形成和感染等术后并发症减少(4.4%对11.7%,P<0.05),平均住院时间更短(5.6±1.8天对8.3±2.4天,P<0.001)。ERAS组患者满意度得分显著更高(94.3%对78.6%,P<0.001)。多变量分析确定基于ERAS原则的围手术期护理是改善康复的独立因素。

结论

ERAS原则指导的围手术期护理显著改善TKA患者的临床结果,减少并发症和住院时间,同时提高患者满意度。本研究支持在围手术期护理中更广泛地实施ERAS方案,以优化手术护理结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd3/12136077/a4bee052fa43/TCRM-21-829-g0001.jpg

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