新型冠状病毒肺炎疫情下髋/膝关节置换术互联网+延续管理模式的构建及应用效果分析

目的探讨新型冠状病毒肺炎疫情下髋/膝关节置换术互联网+延续管理模式的构建与应用效果。方法选择疫情爆发后2020年1月20日至1月31日在华西医院骨科行髋/膝关节置换手术的34例病人纳入观察组,采用互联网+延续管理模式;同时将2019年12月1日至12月20日行髋/膝关节置换手术的34例病人纳入对照组,采用传统延续管理模式。出院当天、出院后2周和出院后1个月,采用Harris髋关节功能评分和美国特种外科医院(Hospital for Special Surgery,HSS)膝关节功能评分评价两组病人髋/膝关节恢复情况,华西心晴指数量表(HEI)评价病人情绪障碍程度;记录术后并发症和病人延续护理满意度。结果观察组病人在互联网+延续管理模式下,未出现新型冠状病毒肺炎确诊病例,情绪亦未受疫情影响。出院后2周和1个月,观察组的髋/膝关节功能评分均高于对照组,差异均有统计学意义(P均<0.05)。两组病人均未发生与髋/膝关节置换术相关的并发症。观察组病人延续护理满意度为100%,优于对照组的85.29%,差异有统计学意义(χ~2=5.397,P=0.020)。结论新型冠状病毒肺炎疫情下,髋/膝关节置换术病人采用互联网+延续管理模式,有效避免了新型冠状病毒肺炎交叉感染,促进了关节置换术后关节功能恢复,且病人心理状况未受疫情影响,无相关并发症发生,保障了病人的医疗安全,提高了延续管理满意度。

Construction and effects of a new model for the Internet plus continuous management for the hip and knee arthroplasty patients under the corona virus disease 2019 epidemic

Objective To explore and analyze a new model for the Internet plus continuous management for the hip and knee arthroplasty patients under the corona virus disease 2019(COVID-19)epidemic.Methods Thirty-four patients who underwent hip/knee replacement surgery in the Orthopaedics Department of West China Hospital from January 20 to January 31,2020 after the outbreak of COVID-19 were selected into the observation group.Thirty-four patients who had hip/knee replacement surgeries during December 1 to December 20,2019 were selected as the control group and they were treated with traditional continuous management mode after discharge.The Harris hip function score and the Hospital for Special Surgery(HSS)knee function score were used to evaluate the hip/knee recovery of patients in the two groups on the day of discharge,2 weeks after discharge and 1 month after discharge.Huaxi emotional-distress index(HEI)score was selected to judge the mood disorder,and the postoperative complications and patient satisfaction of continuing management were recorded.Results No patients in the observation group were infected with the COVID-19 during the epidemic period.Additionally,the emotions of the patients in observation group were not affected by the epidemic.The scores in the hip/knee joint function in the observation group were significantly higher than those in the control group at 2nd week and 1st month after discharge(P<0.05).No postoperative complications of the hip/knee replacement occurred in both groups.The satisfaction of the continuous management in the observation group was 100%,significantly higher than 85.29%in the control group(χ~2=5.397,P=0.020).Conclusion Under the COVID-19 epidemic,we used a novel Internet plus continuous management mode for the hip/knee replacement patients.Such continuous management effectively avoided cross infection,and promoted joint function recovery after joint replacement.In addition,the psychological status of the patients was not affected by the COVID-19 and no related complications occurred during the epidemic.The new model could ensure the medical safety of the patients and improve the continuous management satisfaction.