分析加速康复管理在膝关节炎行膝关节置换术后肺部感染的临床效果。

检索2020年1月至2022年2月PubMed、维普、中国知网、万方等数据库关于加速康复管理在膝关节炎行膝关节置换术中应用的临床随机对照实验(randomized controlled clinical trials, RCTS)，采用Review Manager 5.4软件对纳入文献进行分析。比较膝关节置换术围手术期经加速康复管理为观察组和常规康复管理为对照组，应用美国特种医院膝关节评分(hospital for special surgery knee score, HSS)、视觉模拟评分(visual analogue scale, VAS)及术后并发症。

共纳入12篇文献。膝关节置换术患者1 955例，其中观察组1 007例，对照组948例。两组比较肺部感染[RR＝0.18，95%CI: 0.03～0.96，P＝0.05]；肢静脉血栓[RR＝0.33，95%CI: 0.15～0.69，P＝0.004]、恶心呕吐[RR＝0.30，95%CI: 0.10～0.09，P＝0.04]、压力性损伤[RR＝0.33，95%CI：0.07～1.61，P＝0.17]、切口感染[RR＝0.28，95%CI：0.05～1.64，P＝0.16]、泌尿感染[RR＝0.20，95%CI：0.02～0.17，P＝0.14]。观察组HSS评分高于对照组[MD＝7.83，95%CI：3.17～12.5，P＝0.001]，观察组VAS评分与对照组差异无统计学意义[SMD＝0.39，95%CI：－1.36～0.58，P＝0.43]。

加速康复管理可改善膝关节置换术后膝关节功能，对改善肺部感染和下肢静脉血栓有效，对压力性损伤、切口感染和泌尿感染无明显效果。

To analyze the effect of accelerated rehabilitation management on pulmonary infection after knee arthroplasty for knee arthritis.

Randomized controlled clinical trials (RCTS) on the application of accelerated rehabilitation management in knee arthroplasty for knee arthritis were searched from PubMed, VIP, CNKI, Wanfang and other databases from January 2020 to February 2022, and the included literatures were analyzed by Review Manager 5.4 software. Hospital for special surgery knee score (HSS), visual analogue score (VAS) and postoperative complications were compared between accelerated rehabilitation management (observation group) and conventional rehabilitation management (control group) during perioperative period of knee replacement.

A total of 12 literatures were included. A total of 1 955 patients underwent knee replacement, of which 1007 were in the observation group and 948 were in the control group. Pulmonary infection was compared between the two groups [RR=0.18, 95%CI: 0.03-0.96, P=0.05]. Limb vein thrombosis [RR=0.33, 95%CI: 0.15-0.69, P=0.004], nausea and vomiting [RR=0.30, 95%CI: 0.10-0.09, P=0.04], while the pressure damage [RR=0.33, 95%CI: 0.07-1.61, P=0.17], infection of incision [RR=0.28, 95%CI: 0.05-1.64, P=0.16], urinary infection [RR=0.20, 95%CI: 0.02-0.17, P=0.14]. The HSS score of observation group was higher than that of control group [MD=7.83, 95%CI: 3.17-12.5, P=0.001]. There was no significant difference in VAS score between the observation group and the control group [SMD=0.39, 95%CI: -1.36-0.58, P=0.43].

Accelerated rehabilitation management can effectively improve knee joint function after knee joint replacement and play a beneficial result on lung infection and lower limb venous thrombosis, but has no obvious effect on pressure injury, incision infection and urinary infection.