中国当代医药2024,Vol.31Issue(12) :74-78.

鸡尾酒疗法联合加速康复外科理念在膝关节周围骨折围手术期的应用效果

Effect of cocktail therapy combined with enhanced recovery after surgery concept in the perioperative period of fractures around the knee

周鹏飞 李城至 韦玮
中国当代医药2024,Vol.31Issue(12) :74-78.

鸡尾酒疗法联合加速康复外科理念在膝关节周围骨折围手术期的应用效果

Effect of cocktail therapy combined with enhanced recovery after surgery concept in the perioperative period of fractures around the knee

周鹏飞 1李城至 1韦玮1
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作者信息

  • 1. 甘肃省天水市第四人民医院骨外科,甘肃天水 741000
  • 折叠

摘要

目的 探讨鸡尾酒疗法联合加速康复外科(ERAS)理念对膝关节周围骨折(FAK)患者围手术期的影响.方法 回顾性分析天水市第四人民医院骨科病区2020年1月1日至2022年12月31日收治的86例FAK患者的临床资料,按时间先后分为两组.将2020年1月1日至2021年6月30日收集的病例纳入对照组(n=44),在围手术期给予ERAS干预并于术中相同部位注射等剂量生理盐水;将2021年7月1日至2022年12月31日收集的病例纳入研究组(n=42),在围手术期给与ERAS干预并于术中行鸡尾酒局部注射.观察并比较两组患者的手术相关指标、术后并发症及术后住院时间,并比较两组手术前后各时间点疼痛视觉模拟评分法(VAS)评分、膝关节主动关节活动度(AROM),比较两组围手术期镇痛效果满意度及术后12 h内阿片类药物镇痛使用情况.结果 两组患者均顺利完成手术,均未发生严重术后并发症;研究组的术后住院时间短于对照组,差异有统计学意义(P<0.05);术后各时间点,研究组的VAS评分均低于对照组,AROM均大于对照组,差异有统计学意义(P<0.05);研究组的术后镇痛满意度优于对照组,差异有统计学意义(P<0.05);研究组在术后12 h内阿片类药物镇痛的补救情况少于对照组,差异有统计学意义(P<0.05).结论 鸡尾酒疗法联合ERAS理念可减少术后阿片类药物的使用并有效缓解FAK患者术后早期疼痛,有助于患者术后早期康复训练、加速膝关节功能的恢复,缩短患者住院时间.

Abstract

Objective To investigate the effect of cocktail therapy combined with enhanced recovery after surgery(ERAS)concept in the perioperative period of patients with fractures around the knee(FAK).Methods The clinical data of 86 pa-tients with FAK admitted to the Department of Orthopedics,Tianshui Fourth People's Hospital from January 1,2020 to De-cember 31,2022 were retrospectively analyzed,and they were divided into two groups according to time.The patients col-lected from January 1,2020 to June 30,2021 were included in the control group(n=44),and were given ERAS intervention during the perioperative period and injected with the same dose of normal saline at the same site during the operation.Pa-tients collected from July 1,2021 to December 31,2022 were included in the study group(n=42),and ERAS intervention was given during the perioperative period and cocktail local injection was performed during the operation.The operation re-lated indicators,postoperative complications and postoperative hospital stay were observed and compared between the two groups.The visual analogue scale(VAS)score and knee active range of motion(AROM)at each time point before and after operation were compared between the two groups.The satisfaction of perioperative analgesic effect and the use of opioid analgesia within 12 h after operation were compared between the two groups.Results All patients in the two groups suc-cessfully completed the operation,and no serious postoperative complications occurred.The postoperative hospital stay of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).At each time point after operation,the VAS score of the study group was lower than that of the control group,and the AROM was higher than that of the control group,and the differences were statistically significant(P<0.05).The satisfaction of post-operative analgesia in the study group was better than that in the control group,and the difference was statistically significant(P<0.05).The rescue of opioid analgesia in the study group was less than that in the control group within 12 h after surgery,and the difference was statistically significant(P<0.05).Conclusion Cocktail therapy combined with ERAS concept can reduce the use of opioids and effectively relieve the early postoperative pain of FAK patients,which is helpful for early postoperative rehabilitation,accelerated the recovery of knee joint function,and shortened the length of hospital stay.

关键词

鸡尾酒疗法/加速康复外科/膝关节/膝关节周围骨折

Key words

Cocktail therapy/Enhanced recovery after surgery/Knee joint/Fractures around the knee

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基金项目

甘肃省天水市科技支撑计划(2022-SHFZKJK-3253)

出版年

2024
中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
参考文献量20
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