加速康复外科模式下全膝关节置换术围术期限制性输液的临床研究

发布时间：2018-04-13 05:45

本文选题：加速康复外科 + 全膝关节置换术　；参考：《中国矫形外科杂志》2017年17期

【摘要】：[目的]探讨加速康复外科模式下全膝关节置换术围术期限制性输液的安全性和有效性。[方法]回顾分析2015年7月~2016年1月行初次单侧全膝关节置换术手术当日自由性输液患者90例(对照组)和2016年2月~8月手术当日限制性输液患者70例(限制组)的临床资料。记录并比较两组患者围术期出入量情况、生命体征及不良事件发生情况。[结果]限制组手术当日平均输液量显著低于对照组[(1 532.76±296.51)ml vs(2 303.13±313.35)ml,P0.001]。两组在手术时间、总失血量、术后每小时尿量、围术期血压及心率、术后住院时间方面差异无统计学意义(P0.05)。限制组利尿剂及尿管使用率均低于对照组(11.40%vs 24.40%,P=0.036;15.70%vs 30.00%,P=0.035),但两组术后低血压、低钾血症、恶心呕吐、便秘发生率差异并无统计学意义(P0.05)。[结论]加速康复外科模式下全膝关节置换术围术期采用限制性输液方案(手术当日输液量控制在1 500 ml左右)是安全有效的,但该结论仍需大样本前瞻性研究进一步证实。
[Abstract]:Objective: to investigate the safety and efficacy of peri-operative restrictive infusion of total knee arthroplasty in accelerated rehabilitation surgery.[methods] the clinical data of 90 patients (control group) who underwent the first unilateral total knee arthroplasty during the period of July 2015 to January 2016 and 70 patients with restricted infusion (restriction group) from February to August 2016 were retrospectively analyzed.The perioperative volume, vital signs and adverse events were recorded and compared between the two groups.[results] the average volume of infusion on the day of operation in the restricted group was significantly lower than that in the control group [1 532.76 卤296.51)ml vs(2 303.13 卤313.35ml P0.001].There was no significant difference in operation time, total blood loss, urine volume per hour, perioperative blood pressure and heart rate, postoperative hospitalization time between the two groups (P 0.05).The utilization rate of diuretics and urinary catheter in the restricted group was lower than that in the control group (11.40 vs 24.40). The level of P0. 03615. 70 was lower than that of the control group. However, there was no significant difference in the incidence of hypotension, hypokalemia, nausea and vomiting and constipation between the two groups.[conclusion] it is safe and effective to use the restrictive infusion regimen in the perioperative period of total knee arthroplasty under accelerated rehabilitation surgery (the infusion volume is about 1 500 ml on the day of operation), but this conclusion still needs to be further confirmed by a large sample of prospective studies.
【作者单位】：四川大学华西医院骨科;
【基金】：卫生部2013年度卫生行业科研专项(项目编号:2013020007)
【分类号】：R687.4

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