个案管理模式联合加速康复外科护理在髋关节置换术患者围手术期中的应用

目的探讨个案管理模式联合加速康复外科护理在髋关节置换术患者围手术期中的应用效果。方法采用整群抽样方法,于2018年1月—2020年5月选取南京市第一医院骨科收治的110例髋关节置换术患者为研究对象。按入院顺序的奇偶数将其分为观察组和对照组,两组患者均行硬膜外麻醉后采用髋后外侧切口入路形式。对照组采用加速康复外科护理,观察组采用个案管理模式联合加速康复外科护理进行围手术期管理。观察两组患者术后卧床时间、术后住院时间、住院费用,比较两组术前、术后1 d、术后1个月、术后3个月的Harris评分和视觉模拟评分法(VAS)评分。结果观察组患者术后卧床时间、术后住院时间以及住院费用均低于对照组;观察组患者术前、术后1 d、术后1个月、术后3个月的Harris评分均高于对照组;观察组患者术后1 d、1个月、3个月的VAS评分均低于对照组;以上差异均具有统计学意义(P<0.05)。结论个案管理模式联合加速康复外科理念可加快髋关节置换术患者的术后康复,缩短住院时间,降低住院费用,提高患者的髋关节Harris评分。

Effects of case management mode combined with enhanced recovery after surgery nursing in the perioperative period of patients undergoing hip replacement

Objective To explore the effect of case management mode combined with enhanced recovery after surgery(ERAS)nursing in the perioperative period of hip replacement patients.Methods From January 2018 to May 2020,cluster sampling was used to select 110 patients undergoing hip replacement who were admitted to the Department of Orthopedics,Nanjing First Hospital as the research object.According to the odd and even number of admission order,patients were divided into observation group and control group.After epidural anesthesia,patients in both groups were treated with posterolateral hip incision approach.Control group carried out ERAS nursing,and observation group implemented case management mode combined with ERAS nursing for perioperative management.We observed the intraoperative blood loss,postoperative time in bed,postoperative hospital stay,hospitalization expenses of patients between two groups,and compared the Harris score and Visual Analogue Scale(VAS)of the two groups score before surgery,one day,one month and three months after surgery.Results The intraoperative blood loss,postoperative time in bed,postoperative hospital stay and hospitalization expenses of observation group were lower than those of control group;the Harris scores of observation group before surgery,one day,one month and three months after surgery were higher than those of control group;the VAS scores of patients in observation group were lower than those of control group at one day,one month and three months after surgery;the differences were all statistically significant(P<0.05).Conclusions Case management mode combined with ERAS nursing can accelerate the postoperative rehabilitation of patients undergoing hip replacement,shorten the hospital stay,reduce the hospitalization expense,and improve the hip joint Harris score of patients.