加速康复外科在肥胖患者膝关节置换术中的应用
发布时间：2018-11-09 11:59
【摘要】：目的探索加速康复外科(ERAS)策略在肥胖患者全膝关节置换术的应用方式及临床效果。方法选取行单侧全膝关节置换术的肥胖患者共76例,其中采用常规围手术期处理的共43例(常规组),采用ERAS的肥胖患者共33例(ERAS组)。对比分析(1)两组患者手术前、术后3、7、14 d的膝关节HSS评分及活动度(ROM);(2)手术前后的血红蛋白(Hb)和白蛋白(Alb)、胃肠动力恢复时间和恶心呕吐程度;(3)术后疼痛程度、术后住院时间以及术后并发症。结果两组患者入院时的Hb和Alb比较差异无统计学意义(P0.05),术前ERAS组的Hb和Alb显著高于常规组,差异有统计学意义(P0.01)。而术后1、7 d时ERAS组Hb和Alb均显著高于常规组(P0.01)。ERAS组的术后胃肠道功能恢复时间,包括肠鸣音恢复时间、肛门排气时间、肛门排便时间均显著少于常规组(P0.05)。ERAS组恶心程度为Ⅰ级和Ⅱ级的比例显著高于常规组(P0.05)。术后各时间的VAS评分比较,ERAS组显著低于常规组(P0.01),HSS评分ERAS组显著高于常规组(P0.05),术后14 d ERAS组膝关节ROM显著高于常规组(P0.01),ERAS组并发症的发生率显著低于常规组(P0.05)。结论ERAS加快肥胖患者全膝关节置换术术后早期胃肠道功能恢复,减少术后疼痛和相关并发症的发生,加快了膝关节功能的康复速度。
[Abstract]:Objective to explore the application and clinical effect of accelerated rehabilitation surgery (ERAS) strategy in total knee arthroplasty in obese patients. Methods A total of 76 obese patients undergoing unilateral total knee arthroplasty were selected, 43 of whom were treated with routine perioperative treatment (routine group) and 33 with ERAS (ERAS group). (1) the HSS score and (ROM); (_ 2 of knee joint before and after operation were compared between the two groups. The recovery time of gastrointestinal motility of hemoglobin (Hb) and albumin (Alb), before and after operation and the degree of nausea and vomiting were compared. (3) postoperative pain, postoperative hospital stay and postoperative complications. Results there was no significant difference in Hb and Alb between the two groups at admission (P0.05). The Hb and Alb of preoperative ERAS group were significantly higher than that of routine group (P0.01). On the 7th day after operation, Hb and Alb in ERAS group were significantly higher than those in routine group (P0.01). ERAS group). The anal defecation time was significantly lower than that in the routine group (P0.05). The proportion of nausea grade 鈪，
本文编号：2320350
[Abstract]:Objective to explore the application and clinical effect of accelerated rehabilitation surgery (ERAS) strategy in total knee arthroplasty in obese patients. Methods A total of 76 obese patients undergoing unilateral total knee arthroplasty were selected, 43 of whom were treated with routine perioperative treatment (routine group) and 33 with ERAS (ERAS group). (1) the HSS score and (ROM); (_ 2 of knee joint before and after operation were compared between the two groups. The recovery time of gastrointestinal motility of hemoglobin (Hb) and albumin (Alb), before and after operation and the degree of nausea and vomiting were compared. (3) postoperative pain, postoperative hospital stay and postoperative complications. Results there was no significant difference in Hb and Alb between the two groups at admission (P0.05). The Hb and Alb of preoperative ERAS group were significantly higher than that of routine group (P0.01). On the 7th day after operation, Hb and Alb in ERAS group were significantly higher than those in routine group (P0.01). ERAS group). The anal defecation time was significantly lower than that in the routine group (P0.05). The proportion of nausea grade 鈪，
本文编号：2320350
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