探讨快速康复外科(FTS)理念在老年患者首次单膝关节置换术围手术期的应用效果。

选取2019年2月至12月在解放军火箭军特色医学中心首次行单膝关节置换术的130例老年患者，纳入观察组，接受FTS理念的护理程序；选取2018年8月至2019年2月在解放军火箭军特色医学中心首次行单膝关节置换术的98例老年患者，纳入对照组，接受一般护理程序。比较2组手术患者术前宣教合格率、术中低体温发生率、手术时间、术后早期下床活动时间、住院费用、住院时间、术后并发症、术后患者对疼痛的满意度。对数据行t检验和χ²检验。

观察组与对照组患者术前宣教合格率分别为95.38%、86.73%，差异有统计学意义(χ²＝5.473，P＝0.019)。观察组与对照组患者术中低体温发生率分别为5例(3.85%)、12例(12.24%)，比较差异有统计学意义(χ²＝5.712，P＝0.017)；观察组与对照组患者的手术时间分别为(223.38±10.46)、(249.90±9.90) min，比较差异有统计学意义(t＝19.542，P＝0.017)；观察组与对照组患者术后早期下床活动时间分别为(3.08±1.02)、(56.74±6.89) h，比较差异有统计学意义(t＝64.894，P<0.05)；观察组与对照组患者的住院费用分别为(64 352.24±1 893.95)、(74 010.95±2 055.61)元，比较差异有统计学意义(t＝36.323，P＝0.029)；观察组与对照组患者住院时间分别为(7.31±0.63)、(13.93±0.60) d，比较差异有统计学意义(t＝80.816，P＝0.042)；观察组与对照组患者术后并发症发生率分别为3.07%(4/130)、14.28%(14/98)，比较差异有统计学意义(χ²＝13.644，P＝0.034)；观察组患者满意度为126例(96.92%)，对照组患者满意度为89例(90.81%)，比较差异有统计学意义(χ²＝9.035，P＝0.029)。

FTS理念下的手术护理干预能促进患者术后早期恢复、提高患者对围手术期疼痛满意度、减少患者术后并发症、减轻患者的经济负担，值得临床推广。

To investigate the effect of fast tract surgery (FTS) theory in the perioperative period of primary single knee arthroplasty in elderly patients.

One hundred and thirty elderly patients underwent primary single knee arthroplasty at the PLA Rocket Force Characteristic Medical Center from February to December 2019 were taken into the observation group which were assigned to receive perioperative nursing based on the FTS. Ninety-eight elderly patients underwent primary single knee arthroplasty at the PLA Rocket Force Characteristic Medical Center from August 2018 to February 2019 were taken into the control group which received routine nursing. The qualified rate of preoperative education, the incidence of intraoperative hypothermia, time of the operation, postoperative early ambulation time, hospital expenses, the length of hospital stay, the incidence of postoperative complications and satisfaction to postoperative pain in the two groups were compared. Date were processed t test and chi-square test.

The rates of qualified preoperative education were 95.38% in the FTS group and 86.73% in the control group respectively, the difference was statistically significant(χ²=25.473, P=0.019). The incidences of hypothermia were 5 cases (3.85%) in the FTS group and 12 case (12.24%) in control group respectively, the difference was statistically significant(χ²=25.712, P=0.017). The surgical time in the FTS group was (223.38±10.46) min, which was shorter than that in the control group (249.90±9.90) min, the difference was statistically significant(t=19.542, P=0.017). The time to ambulation in FTS group was (3.08 ± 1.02) h, which was shorter than that in the control group (56.74±6.89) h, the difference was statistically significant (t= 64.894, P<0.05). The hospitalization cost in the FTS group was (64 352.24±1 893.95) yuan, which was less than that in the control group [(74 010.95±2 055.61) yuan], the difference was statistically significant(t=36.323, P=0.029). The length of hospital stay in the observation group was (7.31±0.63) d, which was less than that in the control group [(13.93±0.60) d)], the difference was statistically significant (t=80.816, P=0.042). The incidence of postoperative complications in the FTS group was 3.07% (4/130), which was s lower than that in the control group [14.28% (14/98)], the difference was statistically significant(χ²=213.644, P=0.034). The satisfaction of patients in the FTS group was 126 cases (96.92%). In the control group, the satisfaction of patients was 89 cases (90.81%). The difference was statistically significant between groups (χ²=9.035, P=0.029).

Surgical nursing intervention under the concept of FTS can promote postoperative recovery, improve patients′ satisfaction with postoperative pain treatment, reduce postoperative complications and lower hospitalization cost compared with routine nursing. It is worthy of clinical promotion.