在TKA中现代疼痛管理后量化液体保留:一项观察性研究
Parkpoom Somrak1,2,3, Aree Tanavalee4,5,6, Srihatach Ngarmukos2,3
1Advanced Arthritis and Arthroplasty Center, Department of Orthopaedics, Bumrungrad International Hospital, Bangkok, Thailand.
Knee surgery & related research
|December 16, 2024
概括
在全膝关节整形术 (TKA) 后的留液在术后第三天达到顶峰,并在6周后恢复到基线. 建议对患者进行关于在出院后管理流体变换的教育.
科学领域:
- 整形外科手术 整形外科手术
- 流体生理学 流体生理学
- 术后护理 术后护理
背景情况:
- 手术后的流体保留在像全膝关节整形术 (TKA) 这样的重大手术后很常见.
- 现代的疼痛管理和早期出院协议可能会加剧TKA后的液体保留.
- 缺乏当代TKA疼痛管理后流体变化的定量数据.
研究的目的:
- 在接受TKA的患者中量化外科手术期间的全体水 (TBW) 变化.
- 为了分析TKA后流体保留的时间进展.
- 为了将液体保留与疼痛管理协议相关联.
主要方法:
- 监测了接受初级单边TKA的85名患者.
- 多频生物电阻分析 (BIA) 用于五次扫描:基线,POD 1,POD 3,2周和6周.
- 评估了TBW,体重和并发症的变化.
主要成果:
- 70名患者完成了这项研究;大多数是女性,平均年龄为69.5岁.
- 平均TBW在POD1上增加了2.61L,在POD3上达到3.2L的峰值,在6周后恢复到基线.
- 平均体重在POD1上增加了2.8公斤,在POD3上达到3.42公斤的峰值,并在6周后恢复到基线.
结论:
- 在多式疼痛控制下TKA后的液体保留在术后增加,在POD3达到峰值,并在6周内消失.
- 早期出院协议需要对患者进行关于潜在的液体保留的教育.
- 了解流体动力学对于优化TKA恢复至关重要.
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
01:22Acute Kidney Injury VI: Nursing Management
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...