髋膝置换术后即日与次日下地活动的比较

Comparison of same- day and next- day ambulation after total hip and knee arthroplasty

摘要:

[目的]比较髋膝置换术后即日与次日下地活动的临床早期结果。[方法]2020 年 11 月—2021 年 5 月在本院骨科行初次全髋关节置换术（total hip arthroplasty, THA）及全膝关节置换术（total knee arthroplasty, TKA）患者随机将其分为两组，当日组 66 例，术后即刻负重活动；次日组 74 例，术后次日负重活动。比较两组围手术期、随访资料。[结果]当日组患者首次下床时间、排大便时间显著早于次日组（P＜0.05），当日组患者恶心、呕吐发生率显著低于次日组（P＜0.05）。与术前相比，术后 3、6 周，两组患者髋关节 Harris 评分、膝关节 KSS 评分均显著增加（P＜0.05）。当日组术后 6 周髋关节 Harris 评分、术后 3 周膝关节 KSS 评分均显著优于次日组（P＜0.05）。[结论]THA/TKA 患者术后即刻下地活动在没有显著增加并发症的前提下可促进患者肠道功能及关节功能恢复。

Abstract:

[Objective] To compare the early clinical outcomes of same-day (SD) and next-day (ND) ambulation after hip and knee re- placement. [Methods] The patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in our hospital from No- vember 2020 to May 2021 were randomly divided into two groups. Of them, 66 patients in the SD group resumed ambulation in the same day of operation, while the other 74 patients in the ND group carried out ambulation next day after surgery. The documents regarding periopera- tive period and follow-up were compared between the two groups. [Results] The SD group got out of bed and excreting stool first time after operation significantly earlier than the ND group (P＜0.05), additionally, the former had significantly lower incidence of nausea and vomiting than the latter (P＜0.05). Compared with those preoperatively, Harris and KSS scores in both groups were significantly increased 3 and 6 weeks after surgery (P＜0.05). The SD group proved significantly superior to the ND group in terms of Harris hip score at 6 weeks after sur- gery and KSS score at 3 weeks after surgery (P＜0.05). [Conclusion] The same-day ambulation after HTA/TKA does promote the recovery of intestinal function and joint function without remarkably increasing complications.