The Application Of The Concept Of Accelerated Rehabilitation In Promoting Early Movement Of Patients After Total Knee Arthroplasty

Objective: The patients who underwent unilateral total knee arthroplasty were enrolled in the study.The accelerated rehabilitation concept was applied to their perioperative nursing,and the effect of promoting the patient’s early post-operative activities was evaluated.The recovery effect was evaluated for clinical work.Provide evidence.Methods: In this study,a historically controlled quantitative study method was used.Patients who underwent unilateral total knee arthroplasty in Jingzhou Central Hospital from January to November 2017 were used as control group.Routine care: preoperative education,fasting for 8 hours,water for 4 hours,postoperative pain management on demand Mainly analgesic,through the hospital electronic medical record data to obtain relevant information;Patients who underwent unilateral total knee arthroplasty at the Jingzhou Central Hospital from January 2018 to October 2018 were used as observation groups to use preoperative education in the accelerated rehabilitation concept and shorten the preoperative fasting time(preoperative ban)6h,no drink for 2h)and early eating,advanced analgesia and multi-mode analgesia,as soon as possible to remove the drainage tube to intervene patients to promote early post-operative activities,compare the two groups of patients after the first postoperative Bed activity time,time of first independent activity,incidence of complications,VAS score and HSS score at different time points after surgery,postoperative hospital stay.Results:(1)Comparison of VAS scores between the two groups at different time points after operation:At 4h,12 h,1d,3d,5d,and 7d after operation,the VAS scores of the experimental group(3.83±1.71;4.04±1.11;3.62±1.13;2.85±1.08;2.46±1.14;2.04±1.37)were significantly lower than those of the control group.(5.29±1.30;5.04±1.82;4.31±0.88;3.46±1.33;3.38±1.13;2.85±1.19),the difference was statistically significant(P<0.05).There was no difference in NRS score between the two groups an 6h after operation.Significance(control group,test group were: 4.68±1.89;4.80±1.71)(P>0.05)(2)Comparison of average postoperative hospital stay,first time of getting out of bed,and time of first independent activity in the two groups:The average postoperative hospital stay in the observation group [(10.73 ± 2.71)d / person ] and the first time to get out of bed([(1.58 ± 1.80)d / person]),the first independent activity time(patients do not need help from the aid The time to be able to move independently()(9.54±2.69)d/person] was significantly lower than that of the control group [(15.69±3.10)d/person,((3.56±1.34)d/person)and [(11.96±2.76))d / person],the difference was statistically significant(t = 6.153,3.205;P <0.05).(3)Comparison of postoperative complications between the two groups:Observation group: 6 cases of postoperative nausea and vomiting,3 cases of deep vein thrombosis(DVT),all of which were intramuscular venous thrombosis;control group: 16 cases of nausea and vomiting occurred after operation,10 cases of DVT,all were intermuscular Venous thrombosis.The difference between the two groups was statistically significant(P<0.05).Among the patients with DVT,4 cases occurred on the healthy side,and no infection or urinary tract infection occurred in either group.(4)Comparison of HSS scores between the two groups:At 1 week,2 weeks,1 month,and 2 months after operation,the HSS scores of the observation group(72.04±5.60;81.30±5.34;88.08±5.74;95.38±3.45)were significantly higher than the control group(62.19±5.89;72.19).± 5.30;80.42 ± 5.02;89.58 ± 4.65),the difference was statistically significant(P < 0.05).Conclusion:Apply accelerated healing concept to perioperative nursing of total knee arthroplasty: effectively relieve postoperative pain;shorten the average postoperative hospital stay and the time of first getting out of bed,the first independent activity time after surgery;reduce the patient’s operation The incidence of complications such as nausea and vomiting,knee flexion limitation,and deep venous thrombosis of lower extremities;effectively promote the recovery of knee joint function.