山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (10): 48-61.doi: 10.6040/j.issn.1671-7554.0.2024.1005
• 骨科加速康复外科专题 • 上一篇
华裔骨科学会骨科康复专业委员会
Orthopaedic Rehabilitation Special Committee of Chinese Speaking Orthopaedic Society
摘要： 旨在基于加速康复外科(enhanced recovery after surgery, ERAS)理念,制定一套全膝关节置换术(total knee arthroplasty, TKA)后膝关节功能加速康复的专家共识,优化围手术期康复措施,促进患者术后快速恢复膝关节功能。共识制定采用德尔菲法,分为线上问卷调研和线上会议两阶段。首先,通信作者起草17项TKA术后加速康复的临床问题,由专家组进行文献检索和总结。50位专家参与匿名调研,并通过投票反馈意见。通过两次线上会议对草案进行讨论和实时投票,最终确定共识内容。共识依据牛津大学循证医学标准对文献证据及推荐强度进行分级,投票结果按同意率划分为:51%~74%为一致,75%~99%为强一致,100%为完全一致。共识总结了术后膝关节功能恢复的13项条目,包括康复评定、患者教育、术前康复训练、术后疼痛管理、睡眠管理、术后早期活动等。大多数条目获得了88%~100%的投票支持,尤其是术后疼痛管理(100%一致)、术后早期活动(95.45%~100%一致)等关键措施,显示出专家的高度共识。康复评定、患者教育等条目也获得了90%以上的强一致性支持。本文涉及的共识内容聚焦于TKA术后膝关节功能的加速康复,有助于临床医师和治疗师在开展术后康复时有所参考,以制订合适的治疗方案。
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