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中华老年骨科与康复电子杂志 ›› 2021, Vol. 07 ›› Issue (04) : 238 -244. doi: 10.3877/cma.j.issn.2096-0263.2021.04.007

护理园地

快速康复病程日记在髋关节置换术中的应用
周雪梅1, 侯苹2, 桂冬梅1, 周惠丽1, 夏畏1, 胡艺3,()   
  1. 1. 225000 扬州大学附属医院骨科
    2. 225000 扬州大学护理学院
    3. 225000 扬州大学附属医院护理部
  • 收稿日期:2020-07-17 出版日期:2021-08-05
  • 通信作者: 胡艺
  • 基金资助:
    扬州大学附属医院护理科研基金(201701)

The research of patient diary based on the concept of enhanced recovery after surgery in patients undergoing total hip arthaoplasty

Xuemei Zhou1, Ping Hou2, Dongmei Gui1, Huili Zhou1, Wei Xia1, Yi Hu3,()   

  1. 1. Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China
    2. School of nursing, Yangzhou University, Yangzhou 225000, China
    3. Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou 225000, China
  • Received:2020-07-17 Published:2021-08-05
  • Corresponding author: Yi Hu
引用本文:

周雪梅, 侯苹, 桂冬梅, 周惠丽, 夏畏, 胡艺. 快速康复病程日记在髋关节置换术中的应用[J/OL]. 中华老年骨科与康复电子杂志, 2021, 07(04): 238-244.

Xuemei Zhou, Ping Hou, Dongmei Gui, Huili Zhou, Wei Xia, Yi Hu. The research of patient diary based on the concept of enhanced recovery after surgery in patients undergoing total hip arthaoplasty[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(04): 238-244.

目的

探讨基于快速康复理念的病程日记在髋关节置换术患者中的应用效果。

方法

前瞻性收集2018年1月至2018年12月我院接受髋关节置换手术的患者110例,通过随机数字表法分为对照组55例:男性13例,女性42例,平均年龄(74.8±1.1)岁;试验组55例:男性19例,女性36例,平均年龄(75.3±0.8)岁。对照组行常规围术期护理;试验组在此基础上,护理人员指导患者及家属记录"基于快速康复理念的病程日记本"。观察并随访两组患者的疼痛控制结局、髋关节Harris评分及生活自理能力Barthel指数。

结果

107例患者均获得完整随访,随访率97.3%,试验组和对照组于出院时、出院后1个月、出院后3个月进行随访,平均随访时间(3.70±0.37)个月。试验组患者出院时疼痛控制结局各维度得分:疼痛程度(2.8±0.6)分、疼痛影响(3.0±0.8)分、疼痛控制满意度(5.1±0.8)分、疼痛信念(1.9±0.7)分;术后1个月Harris评分(67.4±5.2)分、生活自理能力Barthel指数(74.6±4.1)分;术后3个月髋关节Harris评分(89.7±5.5)分、生活自理能力Barthel指数(90.2±3.6)分,各项指标得分均优于对照组,差异有统计学意义(P<0.01)。

结论

应用基于快速康复理念的病程日记本能有效改善患者疼痛控制结局,保证机体营养供给,促进患者髋关节功能恢复,提高生活自理能力,达到快速康复的目的。

Objective

To explore the effect of course diary based on the concept of rapid rehabilitation in patients undergoing total hip replacement.

Methods

110 patients who underwent total hip replacement in our hospital from January 2018 to December 2018 were randomly divided into control group (55 cases) and experimental group (55 cases). The control group received routine perioperative nursing. On this basis, the nursing staff in the experimental group instructed the patients and their families to record "course diary based on the concept of fast-track surgery". The outcome of pain control, Harris score and Barthel index score were observed.

Results

The outcome of pain control in the experimental group at discharge. The Harris score and Barthel Index scores of 1 month and 3 months after operation were higher than those of the control group,the difference was statistically significant (P<0.01).

Conclusion

Using the course diary which based on the concept of fast-track surgery can effectively improve the patient's pain control outcome, ensure the body's nutrition supply, promote the recovery of hip joint function, improve the ability of self-care, and achieve the purpose of rapid rehabilitation.

表1 两组髋关节置换术患者一般资料比较
表2 疼痛评估表
表3 功能锻炼记录表
图1 视觉评分表
表4 两组髋关节置换术患者出院时疼痛控制结局评分的比较(分,±s
表5 两组髋关节置换术患者不同时间髋关节Harris评分比较(分,±s
表6 两组髋关节置换术患者不同时间生活自理能力Bathel指数比较(分,±s
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