摘要
目的探讨快速康复外科理念在骨盆骨折围术期治疗中的应用临床疗效。方法选取2017年2月至2019年1月间在我院骨科接受治疗的骨盆骨折患者97例,随机分为观察组(n=52)和对照组(n=45)。观察组在快速康复外科理念指导下,在围手术期给予骨盆骨折复位固定治疗;对照组采用常规围术期管理方案进行临床处理。观察两组患者治疗前后疼痛等级模拟评分改变,对比两组患者的术中出血量、术后苏醒时间、下床时间、排气时间、住院时间及骨折愈合时间,分析两治疗组围术期相关性并发症情况及术后随访骨盆功能恢复情况,以评估其临床疗效。结果每治疗前两组患者疼痛模拟评分比较,无统计学差异(P>0.05);麻醉苏醒后12 h,观察组疼痛等级水平低于对照组(P<0.05)。观察组治疗前与麻醉苏醒后12 h疼痛评分水平比较,差异有显著统计学意义(P<0.05),对照组两时间监测点比较,差异无统计学意义(P>0.05)。观察组术中出血量与对照组比较,差异无统计学意义(P>0.05);观察组麻醉后苏醒时间、排气时间、下床时间及住院时间均较对照组提前,差异具有统计学意义(P<0.05);治疗后两组骨折愈合时间比较,差异无统计学意义(P>0.05)。治疗过程中,对照组患者围术期相关性并发症情况明显高于观察组(P<0.05);而下肢深静脉血栓发生例数比较,无统计学差异(P>0.05)。治疗后3个月,观察组患者骨盆功能恢复率为82.7%;对照组为80.0%。两组结果差异无统计学意义(P>0.05)。结论快速康复外科理念指导下可有效缓解骨盆骨折患者复位内固定治疗过程中的手术应激反应,降低围手术期相关性并发症风险,促进患者的早期功能恢复。
Objective To explore the clinical effect of perioperative treatment of pelvic fracture with the concept of rapid rehabilitation surgery.Methods From February 2017 to January 2019,97 patients with pelvic fracture treated in our hospital were randomly divided into observation group(n=52)and control group(n=45).The observation group was treated with pelvic fracture reduction and fixation during perioperative period under the guidance of rapid rehabilitation surgery concept,while the control group was treated with routine perioperative management scheme.The changes of analog pain score before and after treatment were observed.The amount of bleeding during operation,the time of awakening after operation,the time of getting out of bed,the time of exhaust,the time of hospitalization and the time of fracture healing in the two groups were compared.The perioperative complications and the recovery of pelvic function in the two groups were analyzed to evaluate their prognosis.Results There was no significant difference in analogue pain scores between the two groups before each treatment(P>0.05);the pain level in the observation group was lower than that in the control group 12 hours after anesthesia recovery(P<0.05).There was significant difference in pain score between the observation group before treatment and 12 hours after anesthesia recovery(P<0.05),but there was no significant difference between the two monitoring points in the control group(P>0.05).There was no significant difference in blood loss between the observation group and the control group(P>0.05);the recovery time,exhaust time,out of bed time and hospitalization time of the observation group were earlier than those of the control group(P<0.05);there was no significant difference in fracture healing time between the two groups after treatment(P>0.05).In the course of treatment,the perioperative complications in the control group were significantly higher than those in the observation group(P<0.05),while there was no significant difference in the number of ca
作者
赵勇
许圣犬
徐修磊
ZHAO Yong;XU Sheng-quan;XU Xiu-lei(Department of Orthopaedics,Alar Hospital,First Division of Xinjiang Production and Construction Corps,Alar City,Xinjiang Province,843300,China)
出处
《岭南现代临床外科》
2020年第2期233-237,242,共6页
Lingnan Modern Clinics in Surgery
关键词
快速康复外科理念
骨盆骨折
复位治疗
临床效果
enhanced recovery after surgery
pelvic fracture
reduction treatment
clinical effect evaluation
