加速康复外科理念在老年人工关节置换术患者围术期管理中的应用

目的探讨加速康复外科(ERAS)理念在老年人工关节置换术患者围术期管理中的应用。方法选取2018年6月至2019年6月择期行人工关节置换术的88例患者为研究对象,采用随机抽签法将其分为对照组和观察组,每组44例。对照组采用常规围术期护理,观察组采用基于ERAS的围术期管理。比较两组的围术期指标、血液流变学、关节恢复及并发症发生情况。结果观察组术后24 h VAS评分低于对照组,首次排尿时间、拔除引流管时间、下床活动时间、住院时间均短于对照组(P<0.05)。术后7 d,观察组的全血高切黏度、全血低切黏度及血浆比黏度低于对照组(P<0.05)。观察组的关节功能恢复优良率高于对照组,并发症总发生率低于对照组(P<0.05)。结论ERAS理念应用于老年人工关节置换术患者围术期管理中,可改善血液流变学,促进关节功能恢复,减少并发症。

Application of the concept of enhanced recovery after surgery in perioperative management of elderly patients undergoing artificial joint replacement

Objective To investigate the application of the concept of enhanced recovery after surgery(ERAS)in perioperative management of elderly patients undergoing artificial joint replacement.Methods A total of 88 patients undergoing artificial joint replacement from June 2018 to June 2019 were selected as study objects and divided into control group and observation group by random lottery,with 44 cases in each group.The control group adopted conventional perioperative nursing,while the observation group adopted perioperative management based on ERAS.Perioperative indexes,hemorheology,joint recovery and complications were compared between the two groups.Results The VAS score at 24 h after operation in the observation group was lower than that in the control group,and the time of first urination,removal time of drainage tube,off-bed ambulation bed and hospitalization time were shorter than those in the control group(P<0.05).At 7 d after operation,the whole blood high shear viscosity,whole blood low shear viscosity and plasma specific viscosity in the observation group were lower than those in the control group(P<0.05).The excellent and good rate of joint function recovery in the observation group was higher than that in the control group,the total incidence of complications was lower than that in the control group(P<0.05).Conclusion The concept of ERAS in the perioperative management of elderly patients undergoing artificial joint replacement can improve hemorheology,promote joint function recovery and reduce complications.