中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
11期
1024-1029
,共6页
石辉%孟涛%尚义美%刘明廷%李健
石輝%孟濤%尚義美%劉明廷%李健
석휘%맹도%상의미%류명정%리건
快速康复外科%前交叉韧带重建%膝关节镜
快速康複外科%前交扠韌帶重建%膝關節鏡
쾌속강복외과%전교차인대중건%슬관절경
Fast track surgery%Reconstruction of anterior cruciate ligament%Arthroscopic
目的 探讨快速康复外科(FrS)技术在膝关节镜下前交叉韧带重建手术中应用的可行性.方法 选取80例前交叉韧带断裂需行韧带重建患者,按治疗方法的不同分为FTS方案治疗(快速康复外科治疗组)42例及传统方法治疗(传统治疗组)38例.比较两组术后不同时间的疼痛程度、膝关节Lysholm评分、生存质量评分(SF-36)、膝关节活动度(ROM)恢复时间、患者满意度[(欧洲满意度调查量表(EUROPEP)]、术后感染发生率、术后住院时间及住院总费用的差异.结果 疼痛视觉模拟评分(VAS)快速康复外科治疗组术后1h为(1.80±1.13)分、6h为(1.91±0.98)分、12 h为(1.73±0.95)分、24h为(1.68±0.65)分、48 h为(1.69±0.90)分明显低于传统治疗组[(7.00±1.56)、(7.41±0.93)、(6.82±1.12)、(6.65±0.76)、(6.34±0.88)分],差异均有统计学意义(P＜0.05或P＜0.01);术后住院时间[(7±1)d与(12±1)d,P=0.021)]、住院总费用[(205 600±7 600)元与(28 600±5 400)元,P=0.042)]明显低于传统治疗组,差异有统计学意义.膝关节ROM恢复时间方面快速康复外科治疗组均明显低于传统治疗组,差异有统计学意义(P均＜0.05).患者满意状况明显高于传统治疗组(P=0.007).Lysholm评分两组术后比较,快速康复外科治疗组(85.1±14.2)分明显高于传统治疗组(73.6±12.3)分;差异有统计学意义(t=2.416,P＜0.05).结论 FTS方案的应用可有效促进前交叉韧带重建术后患者的早期康复,减少并发症,缩短住院时间,降低住院费用,改善患者住院体验,提高患者的满意度,安全可行.
目的 探討快速康複外科(FrS)技術在膝關節鏡下前交扠韌帶重建手術中應用的可行性.方法 選取80例前交扠韌帶斷裂需行韌帶重建患者,按治療方法的不同分為FTS方案治療(快速康複外科治療組)42例及傳統方法治療(傳統治療組)38例.比較兩組術後不同時間的疼痛程度、膝關節Lysholm評分、生存質量評分(SF-36)、膝關節活動度(ROM)恢複時間、患者滿意度[(歐洲滿意度調查量錶(EUROPEP)]、術後感染髮生率、術後住院時間及住院總費用的差異.結果 疼痛視覺模擬評分(VAS)快速康複外科治療組術後1h為(1.80±1.13)分、6h為(1.91±0.98)分、12 h為(1.73±0.95)分、24h為(1.68±0.65)分、48 h為(1.69±0.90)分明顯低于傳統治療組[(7.00±1.56)、(7.41±0.93)、(6.82±1.12)、(6.65±0.76)、(6.34±0.88)分],差異均有統計學意義(P＜0.05或P＜0.01);術後住院時間[(7±1)d與(12±1)d,P=0.021)]、住院總費用[(205 600±7 600)元與(28 600±5 400)元,P=0.042)]明顯低于傳統治療組,差異有統計學意義.膝關節ROM恢複時間方麵快速康複外科治療組均明顯低于傳統治療組,差異有統計學意義(P均＜0.05).患者滿意狀況明顯高于傳統治療組(P=0.007).Lysholm評分兩組術後比較,快速康複外科治療組(85.1±14.2)分明顯高于傳統治療組(73.6±12.3)分;差異有統計學意義(t=2.416,P＜0.05).結論 FTS方案的應用可有效促進前交扠韌帶重建術後患者的早期康複,減少併髮癥,縮短住院時間,降低住院費用,改善患者住院體驗,提高患者的滿意度,安全可行.
목적 탐토쾌속강복외과(FrS)기술재슬관절경하전교차인대중건수술중응용적가행성.방법 선취80례전교차인대단렬수행인대중건환자,안치료방법적불동분위FTS방안치료(쾌속강복외과치료조)42례급전통방법치료(전통치료조)38례.비교량조술후불동시간적동통정도、슬관절Lysholm평분、생존질량평분(SF-36)、슬관절활동도(ROM)회복시간、환자만의도[(구주만의도조사량표(EUROPEP)]、술후감염발생솔、술후주원시간급주원총비용적차이.결과 동통시각모의평분(VAS)쾌속강복외과치료조술후1h위(1.80±1.13)분、6h위(1.91±0.98)분、12 h위(1.73±0.95)분、24h위(1.68±0.65)분、48 h위(1.69±0.90)분명현저우전통치료조[(7.00±1.56)、(7.41±0.93)、(6.82±1.12)、(6.65±0.76)、(6.34±0.88)분],차이균유통계학의의(P＜0.05혹P＜0.01);술후주원시간[(7±1)d여(12±1)d,P=0.021)]、주원총비용[(205 600±7 600)원여(28 600±5 400)원,P=0.042)]명현저우전통치료조,차이유통계학의의.슬관절ROM회복시간방면쾌속강복외과치료조균명현저우전통치료조,차이유통계학의의(P균＜0.05).환자만의상황명현고우전통치료조(P=0.007).Lysholm평분량조술후비교,쾌속강복외과치료조(85.1±14.2)분명현고우전통치료조(73.6±12.3)분;차이유통계학의의(t=2.416,P＜0.05).결론 FTS방안적응용가유효촉진전교차인대중건술후환자적조기강복,감소병발증,축단주원시간,강저주원비용,개선환자주원체험,제고환자적만의도,안전가행.
Objective To investigate the feasibility of fast track surgery (FTS) application in arthroscopic reconstruction of anterior cruciate ligament.Methods A total of 80 cases of anterior cruciate ligament(ACL) tear patients were randomized into two groups.While the experimental group (n =42) was treated with the conception of FTS, and the control group(n =38) was treated with the traditional methods.The postoperative pain, knee Lysholm score, quality of life score (SF-36), knee joint activity (EUROPEP), and postoperative infection were compared between the two groups.Result The VAS score of post-operation pain (VAS) 1 h(1.80±1.13) ,6 h(1.91±0.98), 12 h(1.73±0.95) ,24 h(1.68±0.65) ,48 h(1.69±0.90) ,the time stay in hospital (7 ± 1), total cast (205 600 ± 7 600) yuan, were significantly decreased compared to the traditional therapy group(VAS : (7.00± 1.56), (7.41±0.93), (6.82±1.12), (6.65±0.76), (6.34±0.88) ,P ＜0.05 or P＜0.01;(12± 1) d, P =0.021;(28 600±5 400) yuan, P =0.042).Recovery time of ROM of experimental group was significant lower than control group (P ＜ 0.05).But the comparison of patients, satisfaction of post-operation in two groups was inverse(P=0.007).The Lycholm scores of post-operation of FTS group were remarkably higher than the control group and the scores of prior treatment(85.1 ± 14.2) vs (73.6 ±12.3);P＜ 0.05).Conclusion The new methods of FTS can apparently accelerates recovery after ACL reconstruction,reduces complications, shorten time stay in hospital, cut down the total cost, and improve the experience and the satisfaction of patients.It was safety and feasible.
