ERAS理念指导下围手术期护理干预对机器人辅助全膝关节置换术患者的影响

The Effect of ERAS Concept-Guided Perioperative Care Intervention on Patients Undergoing Robot-Assisted Total Knee Arthroplasty

摘要: 目的：观察快速康复外科(ERAS)理念指导下围手术期护理干预措施对机器人辅助全膝关节置换术患者的临床应用及效果评价。方法：选取新疆医科大学第六附属医院2023年8月至2024年4月在腰硬联合麻醉下行单侧机器人辅助全膝关节置换术的患者75例，分为对照组36例和观察组39例。对照组采用常规围手术期护理干预措施，观察组采用ERAS理念指导下围手术期护理干预措施。比较两组围手术期指标(术后首次下床活动时间、尿管拔除时间)、术后视觉模拟评分法(VAS)评分、美国特种外科医院(HSS)评分、美国膝关节协会(KSS)评分、膝关节主动活动度(ROM)、护理满意度及住院时间。结果：与对照组相比，采取ERAS理念指导下围手术期护理干预措施后，观察组术后首次下床活动时间为(23.06 ± 1.17)小时，尿管拔除时间为(6.82 ± 0.76)小时，均短于对照组，差异具有统计学意义(P < 0.05)；观察组术后第一天VAS评分为(4.46 ± 0.79)分，术后第七天VAS评分为(2.21 ± 0.66)分；术后第七天HSS评分为(59.31 ± 2.36)分，术后第一个月HSS评分为(81.38 ± 2.16)分；术后第一个月KSS评分为(78.38 ± 2.20)分；术后第一个月ROM为(110.00 ± 2.56)；出院时护理满意度评分为(95.79 ± 0.81)分；平均住院天数为(11.15 ± 1.25)天，均优于对照组，差异均具有统计学意义(P < 0.05)。结论：ERAS理念指导下围手术期护理措施对加速机器人全膝关节置换术患者膝关节康复进程有着良好的临床应用价值。

Abstract: Objective: To observe the clinical application and effect evaluation of perioperative nursing interventions guided by the concept of rapid recovery surgery (ERAS) on patients undergoing robot-assisted total knee arthroplasty. Methods: A total of 75 patients undergoing unilateral robot-assisted total knee arthroplasty under combined spinal-epidural anesthesia from August 2023 to April 2024 in the Sixth Affiliated Hospital of Xinjiang Medical University were enrolled, and they were divided into control group (36 cases) and observation group (39 cases). The control group was treated with conventional perioperative nursing interventions, and the observation group was guided by ERAS concept. The perioperative indexes (time to first get out of bed after surgery, time to urethral catheter removal), postoperative visual analogue scale (VAS) score, American Hospital for Special Surgery (HSS) score, American Knee Association (KSS) score, knee active range of motion (ROM), nursing satisfaction and hospital stay were compared between the two groups. Results: Compared with the control group, the time of first postoperative activity and the time of urethral catheter removal in the observation group were (23.06 ± 1.17) hours, and the time of urethral catheter removal was (6.82 ± 0.76) hours, which were shorter than those in the control group, and the difference was statistically significant (P < 0.05), and the VAS score of the observation group was (4.46 ± 0.79) on the first day after operation, and (2.21 ± 0.66) on the seventh day after operation. The HSS score was (59.31 ± 2.36) on the seventh day and (81.38 ± 2.16) on the first month after operation. The KSS score in the first month after surgery was (78.38 ± 2.20). The ROM in the first month after surgery was (110.00±2.56); The nursing satisfaction score at discharge was (95.79 ± 0.81). The average length of hospital stay was (11.15 ± 1.25) days, which was better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: Perioperative nursing measures under the guidance of ERAS concept have good clinical application value in accelerating the knee rehabilitation process of patients undergoing robotic total knee arthroplasty.