加速康复外科理念对高龄患者全膝关节置换术后康复的影响

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Abstract Objective To investigate the effect of the concept of accelerated rehabilitation surgery on the rehabilitation of elderly patients with osteoarthritis after total knee arthroplasty. Methods From January 2018 to January 2020, 86 elderly patients undergoing knee arthroplasty in the First People′s Hospital of Dongcheng District, Beijing were selected. Group E and Group T were divided according to the random number table method. Group E (n = 43) was guided by the concept of accelerated rehabilitation surgery during perioperative management, while group T (n = 43) was treated with routine therapy. Pittsburgh sleep quality score (PQSI) was recorded before surgery and 24 h after surgery and nausea and vomiting score (PONV) was recorded 24 h after surgery. Fasting blood glucose levels on the second day of admission, the morning of surgery, 24 h and 48 h after surgery, visual analogue scale (VAS) at 24 h and 48 h after surgery, the Amercian knee society (AKS) before and seven days after surgery, preoperative duration of abstinence, intraoperative fluid inflow and outflow, time of first getting out of bed and length of stay were recorded. Results PQSI score 24 h after surgery in group T was higher than that before surgery, and PQSI score at 24 h after surgery in group E was lower than that in group T, with statistically significant differences (P ＜ 0.05); Compared with group T, fasting blood glucose in group E on the morning of operation, 24 h and 48 h after operation showed statistically significant differences (P ＜ 0.05). Comparison of fasting blood glucose in T group at each time point showed statistically significant difference (P ＜ 0.05). There was no significant difference in fasting blood glucose and on the second day of admission and the morning of operation in group E （P ＞ 0.05）. The differences between the remaining time points were statistically significant (all P ＜ 0.05); VAS score at 24 h and 48 h after surgery in group E were lower than those in group T, and 48 h after surgery in group T was lower than that 24 h after surgery, with statistically significant differences (all P ＜ 0.05); AKS scores on seven days after surgery showed statistically significant differences between and within the two groups (P ＜ 0.05 or P ＜ 0.01). There were statistically significant differences between the two groups in the duration of abstinence, time of first getting out of bed, length of hospital stay, total amount of fluid input, blood loss and urine output (all P ＜ 0.05 or P ＜ 0.01). Conclusion The concept of accelerated rehabilitation surgery has a significant impact on the perioperative rapid rehabilitation of elderly patients with osteoarthritis, which can significantly improve the perioperative discomfort of patients, maintain a stable internal environment, and is conducive to postoperative rehabilitation and reduce the length of hospital stay.

Key words： Enhanced recovery after surgery Elderly Total knee arthroplasty Perioperative rapid rehabilitation

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	LU Haiyan1 DU Shaojie2 YANG Liqiang3▲

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LU Haiyan1 DU Shaojie2 YANG Liqiang3▲. Influence of the concept of accelerated rehabilitation surgery on the rehabilitation of elderly patients after total knee arthroplasty[J]. 中国医药导报, 2020, 17(24): 177-180.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I24/177

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