组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (5): 492-.

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髋膝关节置换围术期快速康复综合管理体系中禁食时间对高龄患者术后康复的影响

  

  • 出版日期:2023-10-09 发布日期:2023-11-01

Effect of fasting time on postoperative rehabilitation of elderly patients in perioperative rapid rehabilitation integrated management system of hip and knee arthroplasty #br#

Effect of fasting time on postoperative rehabilitation of elderly patients in perioperative rapid rehabilitation

integrated management system of hip and knee arthroplasty

  • Online:2023-10-09 Published:2023-11-01

摘要:

 目的 探讨髋膝关节置换围术期快速康复综合管理体系中的术前禁食时间对高龄患者术后康复的影响。方
法 依据术前禁食时间管理方式不同,将 2018 年 7 月至 2021 年 6 月行髋膝关节置换的高龄患者(>80 岁)随机分
为对照组和快速康复组。对照组 380 例患者采用传统禁食方案,快速康复组 380 例依据快速康复理念及精细化护理
流程,制定个性化禁食方案,基本参照术前 2 h 禁清流质,术前 4 h 禁半流质,术前 6 h 禁固体饮食。比较两组患者
实际禁食时间、术前患者要求补液比例、误吸发生率、术后恶心呕吐等消化道症状发生率、术后下地时间、术后住院
日及随访时患者关节功能评分。结果 对照组术前禁食时间显著长于快速康复组 ;术前患者要求补液比例对照组显
著高于快速康复组 ;两组患者均未出现术中和术后误吸 ;术后恶心呕吐发生率对照组显著高于快速康复组 ;术后下
地时间对照组显著长于快速康复组 ;术后住院日对照组平均值大于快速康复组,但无统计学意义 ;术后 6 周关节功
能评分两组无显著差别。结论 采用快速康复及精细护理理念,个性化制定髋膝关节置换术前禁食时间,可显著减
少术后胃肠道不适发生率,改善短期康复速度,缩短术后住院日,但对术后 6 周及以上时间患者关节功能无显著影响。

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Abstract:

Objective To explore the effect of preoperative fasting time on postoperative rehabilitation of elderly patients in
perioperative rapid recovery comprehensive management system of hip and knee replacement. Methods According to different
preoperative fasting time management methods, elderly patients (>80 years old) who underwent hip and knee replacement from
July 2018 to June 2021 were randomly divided into control group and fast recovery group. A total of 380 patients in the control
group were given the control fasting program, and 380 patients in the fast recovery group were given the personalized fasting program according to the fast recovery concept and refined nursing process, basically referring to no clear fluid 2 hours before operation, no semi-fluid 4 hours before operation, and no solid diet 6 hours before operation. The actual fasting time, the proportion
of patients requiring fluid rehydration before operation, the incidence of aspiration, the incidence of postoperative gastrointestinal
symptoms such as nausea and vomiting, the postoperative ground time, the postoperative hospital stay and the joint function score
during follow-up were compared between the two groups. Results The fasting time of the control group was significantly longer
than that of the fast recovery group. The proportion of patients requiring fluid rehydration before operation in control group was
significantly higher than that in fast recovery group. There was no intraoperative and postoperative aspiration in the two groups.
The incidence of postoperative nausea and vomiting in control group was significantly higher than that in fast recovery group. The
postoperative ground time in the control group was significantly longer than that in the fast recovery group. The average length
of postoperative hospital stay in the control group was higher than that in the fast recovery group, but there was no statistical
significance. There was no significant difference in joint function score between the control group and the fast recovery group at
6 weeks after operation. Conclusion Using the concept of fast recovery and fine nursing, personalized setting of fasting time
before hip and knee replacement can significantly reduce the incidence of postoperative gastrointestinal discomfort, improve the
short-term recovery speed, shorten the postoperative hospital stay, but has no significant effect on the joint function of patients 6
weeks and more after surgery.

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