关节镜下肩袖损伤修复快速康复的初期结果

Initial outcomes of fast- track principles used in arthroscopic rotator cuff repair

摘要:

[目的]探讨快速康复外科理念(fast track surgery, FTS)在肩袖损伤围手术期的应用和初期效果。[方法]2020 年 7 月—2021 年 7 月，112 例肩袖损伤患者随机分为两组，两组均行镜下肩袖修复术。57 例采用 FTS 围手术期诊疗措施，55 例采用常规诊疗措施。比较两组患者输液时间、住院时间、并发症发生率、满意度评分、疼痛 VAS 评分等指标。[结果]两组患者性别、年龄、病因、合并症、手术时间的差异无统计学意义 (P＞0.05)。FTS 组术后输液时间、住院时间、并发症发生率均少于常规组，差异有统计学意义(P＜0.05)。FTS 组满意度评分高于常规组，差异有统计学意义(P＜0.05)。术前 1 d 和术后 7 d 两组患者 VAS 评分的差异无统计学意义 (P＞0.05)；但是，手术当日和术后 3 d 时 FTS 组的 VAS 评分显著低于常规组 (P＜ 0.05)。[结论]快速康复外科理念在肩袖损伤围手术期的应用能够减轻患者疼痛，减少并发症，提高患者满意度。

Abstract:

[Objective] To explore the initial outcomes of fast-track surgery (FTS) principles used in arthroscopic rotator cuff repair. [Methods] From July 2020 to July 2021, 112 patients with rotator cuff injury were randomly divided into two groups. All the patients re- ceived arthroscopic rotator cuff repair, of them, 57 patients were treated with FTS perioperative management, while the other 55 patients were treated with conventional treatment. The VAS score, infusion time, hospital stay, incidence of complications, patient's satisfaction were compared between the two groups. [Results] There was no significant difference in gender, age, cause of rotator cuff tear, comorbidity and operation time between the two groups (P＞0.05) . However, the FTS group proved significantly superior to the conventional group in terms of time of postoperative infusion, hospital stay and incidence of complications (P＜0.05) . In addition, the FTS group had significantly higher satisfaction score than the conventional group at discharge (P＜0.05) . Regarding to pain, the FTS group had significantly lower VAS score than the conventional group on the day of surgery and 3 days after operation (P＞0.05) , despite of the fact that no a statistically signifi- cant difference in VAS score between the two groups was noted before and 7 days after operation (P＞0.05) . [Conclusion] The application of fast-track surgery principles in arthroscopic rotator cuff repair does relieve pain, reduce complications and improve patient satisfaction.