Enhanced Recovery After Surgery Of Traditional Chinese Medicine Clinical Nursing Pathway In Application Of Total Hip Arthroplasty In Patients

ObjectiveTo establish the clinical nursing path of Chinese medicine for rapid rehabilitation of total hip arthroplasty.To explore the effect of rapid rehabilitation of traditional Chinese medicine clinical nursing path in total hip arthroplasty.MethodsThrough literature research,case review,operational process reorganization and Delphi method,the rapid rehabilitation of traditional Chinese medicine clinical nursing path was constructed.Sixty-six patients who underwent total hip arthroplasty from April 2020 to April 2021 were selected by convenience sampling method.The patients were divided into experimental group(n=34)and control group(n=32)by simple random grouping method.The experimental group was given rapid rehabilitation of traditional Chinese medicine clinical nursing path,and the control group was given orthopedic routine nursing.The general data survey,S AS anxiety self-rating score,patient satisfaction score,Harris hip function score,postoperative first exhaust and time out of bed,length of hospital stay and postoperative complications were compared between the two groups.Collect data,make statistical analysis and write papers.Results1.Results of Delphi method:①Expert positive coefficient:the recovery rate of the first round of expert letter consultation was 100%,and that of the second round was 100%;②The degree of authority of expert opinions Cr=0.875;(3)In the first round of expert letter consultation,there were 5 indexes,27 indexes and 111 indexes in the first,second and third levels respectively.The first,second and third indexes of the second round of expert letter consultation were 5,28 and 132 respectively.The mean values of importance of the two rounds of items were 3.8-5,4.15-5,respectively.For the two rounds of expert consultation,the full marks of experts who rated the importance of items above 5 were 5%-100%and 30%-100%,respectively.(4)The coefficient of variation of the items in the first round and the second round of the expert letter questionnaire was between 0-0.24 and 0-0.11,and the significant level of the coordination coefficient was P<0.001,which indicated that the coordination degree of the expert opinions was high and the results were more reliable.(5)Cronbach’s Alpha analysis of the reliability of the two rounds of expert consultation tables in this study showed that there were 111 items in the first round with a α coefficient of 0.94,and 132 items in the second round with a α coefficient of 0.897.2.Clinical application results:① There was no significant statistical difference in the general data of the two groups,indicating that the data of the two groups were comparable.②There were significant differences in the first time of getting out of bed,the first time of exhaust and the length of hospital stay between the two groups(P<0.001).③The number of perioperative complications in the experimental group was significantly lower than that in the control group,with statistical difference(P<0.05);Harris hip score:Harris scores were compared between the two groups at 7 days and 2 months after surgery.The joint activity evaluation of the experimental group was about 55 points on the 7th day after surgery,and it could reach 85 points 2 months after surgery,reaching the standard level,while the joint grade evaluation of the control group was about 46 points on the 7th day after surgery,and it could reach 75 points 2 months after surgery,reaching the medium level.P<0.001;⑤SAS self-rating anxiety scale:after intervention,the score of experimental group(47.50±4.001)was significantly lower than that of control group(51.17±3.201),and compared with before intervention,the anxiety symptoms were greatly improved,the difference was statistically significant(P<0.001).⑥Nursing job satisfaction questionnaire:the satisfaction score of experimental group patients(102.78±3.19)was significantly higher than that of control group(96.53±3.52),the difference was statistically significant(P<0.001).ConclusionThe rapid rehabilitation of traditional Chinese medicine clinical nursing path applied to patients undergoing total hip arthroplasty can effectively shorten the first postoperative exhaust time and the time to get out of bed,shorten the length of hospital stay,reduce the incidence of early postoperative complications,reduce patients’ anxiety and other adverse emotions,improve patient satisfaction,and promote the recovery of hip function.The construction of this pathway is scientific,feasible and practical,and provides a reference scheme for the extensive clinical implementation of the concept of rapid rehabilitation.