基于加速康復理論的精細化護理對機器人輔助膝關節置換術患者的圍手術期應用效果

摘 要 目的：探討基于加速康復理論的精細化護理對機器人輔助膝關節置換術患者的圍手術期應用效果。方法：選取2022年1月—2023年7月在空軍軍醫大學第二附屬醫院行機器人輔助膝關節置換術的112例患者，隨機分為對照組（56例，常規護理干預）和研究組（56例，基于加速康復理論的精細化護理干預），比較兩組圍手術期相關指標、視覺模擬評分法（VAS）疼痛評分、美國特種外科醫院（HSS）膝關節評分以及并發癥發生情況。結果：與對照組相比，研究組手術時間、下床活動時間、進食時間、住院時間更短，住院費用更少，術后8 h、1 d、2 d、3 d VAS評分更低（Plt;0.05）。術后1周、1個月、3個月、6個月，兩組HSS評分較術前均升高，且研究組HSS評分高于對照組（Plt;0.05）。研究組并發癥發生率低于對照組（Plt;0.05）。結論：基于加速康復理論的精細化護理應用于機器人輔助膝關節置換術患者，可縮短手術時間，減少住院費用，減輕術后疼痛，促進膝關節功能恢復，使患者更快康復。

關鍵詞 加速康復外科；精細化護理；機器人輔助手術；膝關節置換術；圍手術期

中圖分類號 R473.6 R687.4 文獻標識碼 A 文章編號 2096-7721（2024）05-0836-06

Perioperative effects of refined nursing care based on ERAS on patients undergoing robot-assisted knee arthroplasty

FENG Qian， LI Hong， CHEN Yan， LUO Jing， ZHU Yan， CAI Pan

（Orthopedic Operating Room， the Second Affiliated Hospital of Air Force Military Medical University， Xi’an 710038， China）

Abstract Objective： To explore the perioperative application effect of refined nursing care based on ERAS on patients undergoing robot-assisted knee arthroplasty. Methods： 112 patients who underwent robot-assisted knee arthroplasty in the Second Affiliated Hospital of Air Force Medical University from January 2022 to July 2023 were selected and randomly divided into the control group （n=56） and the research group （n=56）. The control group received conventional nursing intervention， and the study group received refined nursing intervention based on ERAS. Perioperative indexes， visual analog scale （VAS） score， American Hospital for Special Surgery （HSS） knee score and incidence of complications were compared between the two groups. Results： Compared with the control group， the study group had shorter operative time， time to get out of bed， time to feed and length of hospital stay， less hospitalization cost， and lower VAS scores at 8 h， 1 d， 2 d， and 3 d after surgery （Plt;0.05）. At 1 week， 1 month， 3 months， and 6 months after surgery， HSS scores were higher in both groups compared with those before surgery， and HSS scores were higher in the study group than those in the control group （Plt;0.05）. The incidence rate of complication in the study group was lower than those in the control group （Plt;0.05）. Conclusion： The application of refined nursing care based on ERAS in robot-assisted knee arthroplasty can shorten the operative time， lower hospitalization costs， alleviate postoperative pain， and promote the recovery of knee function.

Key words Enhanced Recovery after Surgery; Refined Nursing; Robot-assisted Surgery; Knee Arthroplasty; Perioperative

Period

隨著醫療技術的不斷進步，機器人輔助膝關節置換術已經成為治療嚴重膝關節疾病的有效手段[1]。然而，圍手術期護理對于患者康復以及手術效果具有至關重要的作用。目前，基于加速康復理論的精細化護理在機器人輔助膝關節置換術患者中得到一定的應用[2]?；诩铀倏祻屠碚摰木毣o理是一種全面、針對患者特定需求的護理模式，旨在提高患者恢復速度、減少并發癥發生率、縮短住院時間，并提高患者的滿意度。……