Applied Research On Fast-track Surgery In Perioperative Care Of Patients With Total Knee Arthroplasty

Objective To investigation the applied effects of the FTS concept in the perioperativenursing of patients with TKA.Then provide the basis for orthopedic medical staff to carry outthe concept of FTS nursing measures.Method I choose a total of76cases of artificial total knee replacement’s patients inNingXia Autonomous Region People’s Hospital since February2012.I have collected standardpatients as control group from February1to June12012, which is the intervention groupfrom July1to November12012. The number of group is38. The control group usingtraditional nursing method and the intervention group using nursing measures with the idea ofcomplying with Fast-track surgery.Using HHS score(hospital for special surgery)andFIM(functional independent measurement) to evaluate the two groups of patients withpostoperative3、7、10d related function of knee joint and functional independence movement.Records the two groups of patients with postoperative time to get out of bed for the first timeand postoperative complications, counted the two groups of patients with an averagepostoperative rehabilitation time and expenses.Concequences1.Age, sex, body mass index, hemoglobin, total protein, fasting blood glucosr, culturaldegree, operation time, preoperative one day of HSS scores and postoperative extubation timewere basically the same in the two groups of patients(p>0.05).2.The intervention group patients’ HSS scores after surgery3、7、10d(33.51±1.75、61.94±2.74、86.89±2.25) were higher than the control group patients’(26.32±2.06、54.09±3.42、80.84±2.86)3.There was no significant difference （p>0.05）in FIM scores between interventiongroup patients(30.21±3.43)and the control group in patient（s29.52±2.66）after surgery3d. But intervention group patients’FIM scores（66.08±2.07、82.88±4.47） were higher than thecontrol group （60.21±2.96、73.06±3.41）after surgery7、10d, which has a significantdifference（p<0.05）.4.Postoperative time to get out of bed for the first time: intervention group patients’(2.04±0.26)was earlier than the control group patients’(3.17±0.64), which has significantdifference(p <0.05). The postoperative complications incidence decreased obviously inintervention group patients (31.6%) compared with the control group (73.7%).5. postoperative rehabilitation time and expenses: postoperative rehabilitation time andexpenses in intervention group patients(12.14±1.01d、35633.56±435.11yuan） reducedsignificantly than in the control group（18.88±4.05d、39763.74±543.04yuan）.Conclusions1.With the concept of Fast-track surgery nursing measures for patients with total knee replacement inperioperative operation nursing.The score of patients postoperative knee function and functionalindependence were significantly improved, the time of postoperative patients lie in bed was cut and thecomplications were reduced, which is conducive to promote patients recover quickly.2.The rapid rehabilitation concept of surgical nursing measures have put into use inpatients with total knee replacement, which effectively shortens the length of hospital stay,reduces postoperative rehabilitation time and expenses and saves medical resources.