|
|
|
| Application effect of the concept of enhanced recovery after surgery in the perioperative period of patients with lumbar degenerative disease |
| FAN Liying ZHANG Gelin WU Wei XUE Jianli CHENG Bin |
| The Third Department of Orthopedics, the Second Affiliated Hospital of Xi′an Jiaotong University, Shaanxi Province, Xi′an 710000, China |
|
|
|
Abstract Objective To explore the application effect of the concept of enhanced recovery after surgery in patients with lumbar degenerative disease during perioperative period. Methods A total of 72 patients diagnosed as degenerative diseases of the lumbar spine in the Third Department of Orthopedics, the Second Affiliated Hospital of Xi′an Jiaotong University from November 2016 to October 2018 who underwent initial surgery were selected as the study objects. According to the random number table method, they were divided into control group and observation group, with 36 cases in each group. The control group used the routine rehabilitation program, the observation group used the enhanced recovery program. Visual analogue scale (VAS) and Japanese orthopaedic Association (JOA) score were observed and recorded before surgery, 1 and 2 weeks after surgery. Results VAS scores 1 and 2 weeks after surgery were lower than those before surgery, and JOA scores were higher than those before surgery, moreover, VAS score 2 weeks after surgery was lower than 1 week after surgery, and JOA score 2 weeks after surgery was higher than 1 week after surgery, with all statistically significant differences (all P ＜ 0.05). VAS and JOA scores were compared between the two groups 1 and 2 weeks after surgery, there were statistically significant differences (all P ＜ 0.05). There was no significant difference in total incidence of postoperative complications between the two groups (P ＞ 0.05). Conclusion The concept of enhanced recorery after surgery is applied to the perioperative period of the first lumbar degenerative disease, which can effectively relieve the pain in the waist and legs of patients, accelerate the early recovery of patients, reduce the occurrence of adverse reactions during the perioperative period, and improve the clinical efficacy.
|
|
|
|
|
|
[1] 中国加速康复外科专家组.中国加速康复外科围手术期管理专家共识（2016）[J].中华外科杂志，2016，54（6）：413-418.
[2] Cheatham SW，Enseki KR，Kolber MJ. Postoperative rehabilitation after hip arthroscopy：a search for the evidence [J]. Sport R ehabil，2015，24（4）：413-418.
[3] 欧会芝，陈玉梅，刘凡，等.快速康复外科理念在腰椎间盘突出症患者围术期护理中的应用效果[J].中国当代医药，2019，26（20）：185-187，191.
[4] 宋宇锋，王安利，武政.主动运动疗法治疗腰椎间盘突出症的疗效及安全性研究[J].中华老年骨科与康复电子杂志，2016，2（4）：228-233.
[5] Von Forell GA，Stephens TK，Samartzis D，et al. Low back pain：a biomechanical rationale based on “patterns” of disc degeneration [J]. Spine，2015，40（15）：1165-1172.
[6] 石秀秀，秦江，唐金树，等.全程系统康复对老年患者单节段腰椎融合术后功能的影响[J].中国疼痛医学杂志，2016，22（9）：672-676.
[7] McGregor AH，Probyn K，Cro S，et al. Rehabilitation following surgery for lumbar spinal stenosis. A Cochrane review [J]. Spine，2014，39（13）：1044-1054.
[8] 杨敏.快速康复外科理念在腰椎间盘突出症患者围术期护理中的应用[J].实用临床医药杂志，2017，21（8）：208-210.
[9] Nanavati AJ. Fast track surgery in the elderly：avoid or proceed with caution [J]. Gastrointest Surg，2015，19（12）：2292-2293.
[10] 唐广梅.快速康复外科理念在腰椎间盘突出症患者围术期护理中的应用[J].医学理论与实践，2019，32（7）：1074-1075.
[11] Connelly M，Fulmer RD，Prohaska J. Predictors of postoperative pain trajectories in adolescent idiopathic scoliosis [J]. Spine，2014，39（3）：E174-E181.
[12] Wainwright TW，Immins T，Middleton RG. Enhanced recovery after surgery （ERAS） and its applicability for major spine surgery [J]. Best Pract Res Clin Anaesthesiol，2016，30（1）：91-102.
[13] 左红霞，张超，黄健健，等.不同术前禁食禁饮时间对我国择期全身麻醉患者围手术期影响的系统评价[J].华西医学，2018，33（8）：1005-1014.
[14] Blichfeldt-Eckhardt MR，Ording H，Andersen C，et al. Early visceral pain predictschronic pain after laparoscopic cholecystectomy [J]. Pain，2014，155（11）：2400-2407.
[15] Reddi D，Curran N. Chronic pain after surgery：Pathophysiology，risk factors and prevention [J]. Postgrad Med J，2014，90（1062）：222-227.
[16] Halawi MJ，Grant SA，Bolognesi MP. Multimodal Analgesia for Total Joint Arthroplast [J]. Orthopedics，2015，38（7）：e616-e625.
[17] Ebenbichler GR，Inschlag S，Pflüger V，et al. Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation operation [J]. Clin Rehabil，2015，29（6）：548-560.
[18] 段丹，宁宁，李佩芳，等.加速康复外科下骨科患者围手术期深静脉血栓形成的预防及管理新进展[J].华西医学，2017，32（9）：1358-1361.
[19] 付凯，佴永军，曹红勇.加速康复外科理念在结直肠手术中的应用状况[J].中国医药导报，2018，15（18）：158-162.
[20] 杨羽芳，何梦蓉，朱晓影，等.快速康复外科理念在老年人工髋关节置换患者护理中的应用效果及对患者满意度的影响观察[J].中国现代医生，2019，57（19）：150-154.
[21] 陈飞，陈莉，王世东，等.多学科协作老年髋部骨折ERAS理念的临床实施及效果评价[J].当代医学，2019，25（18）：142-143.
[22] 丁滨.建立患者安全体系以减少腰椎手术并发症——访海军总医院全军腰椎间盘病诊治中心主任何勃教授[J].临床误诊误治，2015，28（1）：4.
[23] 胡鸢，侯树勋，吴新宝，等.腰椎融合术后早期腰部屈曲训练对腰椎活动度的影响[J].中国骨与关节杂志，2016， 5（3）：175-178.
[24] 林鸿亮，陈善堂，张育专，等.经皮椎体后凸成形术配合腰背肌功能锻炼治疗骨质疏松性腰椎压缩性骨折的效果[J].中外医学研究，2019，17（15）：54-55.
[25] 黎志权.椎间孔镜手术对腰椎间盘突出症患者术后疼痛介质、炎性因子的影响[J].中国医学创新，2019，16（16）：127-130. |
|
|
|
