Citation: | ZHENG Jun, FEI Wenyong, ZHU Changren, HU Yangyang. Effect of whole-process optimization of day surgery in rotator cuff repair under arthroscopy[J]. Journal of Clinical Medicine in Practice, 2023, 27(12): 63-68. DOI: 10.7619/jcmp.20231405 |
To observe the application effect of whole-process optimization of day surgery in rotator cuff repair under arthroscopy.
A total of 140 patients with arthroscopic rotator cuff repair were selected as study objects, and were randomly divided into experimental group(day surgery of whole-process optimization, n=70) and control group(routine inpatient surgical protocol, n=70). The average hospitalization days, hospitalization expenses, postoperative complication, shoulder joint rehabilitation effect of the two groups were compared.
The average hospital stay and preoperative bed stay time of the experimental group were shorter than those of the control group (P < 0.05); the total hospitalization cost and hospitalization cost of the experimental group were lower than those of the control group (P < 0.05); the total incidence of postoperative complications in the experimental group was lower than that in the control group, and the total incidence of postoperative adverse reactions was higher than that in the control group, but the differences were not statistically significant (2.86% versus 4.29%, 15.71% versus 12.86%, respectively, P>0.05). At 1 month, the experimental group had larger forward flexion, abduction, and neutral external rotation motion in the observation group compared to those in the control group(P < 0.05); at 3 months, the experimental group had larger forward flexion, abduction, neutral external rotation motion and lateral internal rotation in the observation group compared to those in the control group(P < 0.05); at 6 months after operation, forward flexion, abduction, and neutral external rotation motion, Constant score and ASES score in the experimental group showed no significant differences between two groups (P>0.05). The pain scores of the experimental group were lower than those of the control group at 1 month, 3 and 6 months after operation (P < 0.05). The educational awareness rate and satisfaction rate of the experimental group were 92.86% and 97.14%, respectively, which were higher than 84.29% and 90.00% of the control group (P < 0.05).
The whole-process optimization of day surgery for patients with arthroscopic rotator cuff repair based on integration of multi-disciplinary medical and nursing resources can effectively shorten hospitalization time, reduce hospitalization costs, and accelerate their recovery.
[1] |
杨晓宇, 王健, 孟彦, 等. 中国日间手术在探索中前行[J]. 中国卫生经济, 2020, 39(4): 19-22. https://www.cnki.com.cn/Article/CJFDTOTAL-WEIJ202004007.htm
|
[2] |
HOPEWELL S, KEENE D J, MARIAN I R, et al. Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2×2 factorial, randomised controlled trial[J]. Lancet, 2021, 398(10298): 416-428. doi: 10.1016/S0140-6736(21)00846-1
|
[3] |
TSUCHIYA S, DAVISON E M, RASHID M S, et al. Determining the rate of full-thickness progression in partial-thickness rotator cuff tears: a systematic review[J]. J Shoulder Elb Surg, 2021, 30(2): 449-455. doi: 10.1016/j.jse.2020.08.022
|
[4] |
刘德鼎, 周冬冬, 张宝, 等. 肩关节前脱位合并骨性Bankart损伤、肩袖损伤及腋神经损伤的关节镜治疗[J]. 骨科临床与研究杂志, 2021, 6(6): 321-326. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC202106001.htm
|
[5] |
ZHU P F, WANG Z C, LI H M, et al. Platelet-rich plasma injection in non-operative treatment of partial-thickness rotator cuff tears: a systematic review and meta-analysis[J]. J Rehabil Med, 2022, 54: jrm00312. doi: 10.2340/jrm.v54.1434
|
[6] |
尚小可, 郑君, 余子杨, 等. 肩袖损伤的处理临床实践指南(2019年)解读[J]. 中华肩肘外科电子杂志, 2021, 9(2): 103-111. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHJW202102004.htm
|
[7] |
马正良, 黄宇光, 顾小萍, 等. 成人日间手术加速康复外科麻醉管理专家共识[J]. 协和医学杂志, 2019, 10(6): 562-569. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX201906004.htm
|
[8] |
AMER M A, SMITH M D, HERBISON G P, et al. Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery[J]. Br J Surg, 2017, 104(3): 187-197. doi: 10.1002/bjs.10408
|
[9] |
FAWCETT W J, THOMAS M. Pre-operative fasting in adults and children: clinical practice and guidelines[J]. Anaesthesia, 2019, 74(1): 83-88. doi: 10.1111/anae.14500
|
[10] |
谢彬, 费文勇, 刘颖, 等. 糖尿病对关节镜肩袖修补术后患者肩关节功能恢复的影响[J]. 中国运动医学杂志, 2021, 40(3): 193-199. https://www.cnki.com.cn/Article/CJFDTOTAL-YDYX202103007.htm
|
[11] |
KEHLET H. Fast-track surgery-an update on physiological care principles to enhance recovery[J]. Langenbecks Arch Surg, 2011, 396(5): 585-590.
|
[12] |
车国卫. 加速康复外科: 临床应用加减之间?[J]. 中国肺癌杂志, 2019, 22(11): 681-686. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ202009006.htm
|
[13] |
陈凛, 陈亚进, 董海龙, 等. 加速康复外科中国专家共识及路径管理指南(2018版)[J]. 中国实用外科杂志, 2018, 38(1): 1-20. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201801001.htm
|
[14] |
郑军, 徐薇, 张铭, 等. 日间手术全周期闭环智慧系统管理实践与成效[J]. 护理学杂志, 2022, 37(3): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202203001.htm
|
[15] |
徐峰, 陈小云, 张秦, 等. 全球肩袖康复十年研究热点和前沿分析[J]. 中华肩肘外科电子杂志, 2021, 9(1): 11-23. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHJW202101006.htm
|
[16] |
莫春丽, 朱清有, 李钊宁, 等. 肩袖损伤患者术后功能康复护理对患者生活质量的影响[J]. 中国卫生标准管理, 2021, 12(6): 150-152. https://www.cnki.com.cn/Article/CJFDTOTAL-WSBZ202106056.htm
|
[17] |
胡洋洋, 王战业, 卢耀甲, 等. 关节镜下打结与无结单线桥技术治疗肩袖滑囊侧撕裂的比较研究[J]. 实用临床医药杂志, 2023, 27(6): 44-50. doi: 10.7619/jcmp.20223149
|
[18] |
方丹灵, 王音, 何汉, 等. 微信结合情景图示的健康教育对开放性肘关节松解术患者康复的影响[J]. 护理学杂志, 2022, 37(16): 1-4. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202216001.htm
|
[19] |
郭彤, 刘心菊, 刘力平, 等. 跨专科护理健康教育平台的应用研究[J]. 中国护理管理, 2021, 21(6): 922-925. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202106027.htm
|
[20] |
柯兰兰, 洪卢晓, 翁晶晶. 日间手术术前管理及效果研究[J]. 医院管理论坛, 2020, 37(5): 14-16. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYG202005005.htm
|