加速康复方案在老年转子间骨折治疗中的应用疗效分析 |
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投稿时间:2018-10-26 修订日期:2018-12-30
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期刊信息:《中国骨伤》年,第卷,第期,第-页 |
DOI: |
基金项目:常州市武进区科技项目(基金号:WS201711) |
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中文摘要:目的 加速康复方案在髋、膝关节置换中的临床效果已经得到证实,本文旨在评估老年转子间骨折治疗中应用加速康复方案的临床价值。方法 筛选2016年1月-2018年10月住院治疗的80例老年转子间骨折,按处置方案不同随机分为加速康复组和传统康复组,每组各40例,加速康复组男22例,女18例,年龄66-92岁,平均78.6岁;传统康复组男19例,女21例,年龄65-91岁,平均80.6岁。比较两组围手术期失血量、并发症发生率、入院到手术时间、住院时间、髋关节Harris评分及改良BADL量表的差异。结果 随访期间两组患者均无切口不良愈合、切口感染、下肢深静脉血栓、肺栓塞等并发症发生,80例患者获得12个月以上的随访,平均随访时间(15.4±2.6)个月。加速康复组围手术期总失血量明显低于传统康复组,差异有统计学差异(P<0.001)。虽然加速康复组的并发症发生率低于传统康复组,但两组比较无统计学差异(p>0.05)。加速康复组入院至手术时间为(1.48±0.51)天,传统康复组入院至手术时间为(4.35±1.55)天,两组比较有统计学差异(t=11.185,p<0.01);加速康复组的住院时间为(6.4±1.1)天,传统康复组的住院时间为(9.9±1.9)天 ,两组比较有统计学差异 (p<0.01)。术后12个月时两组的髋关节Harris评分比较无显著差异(p>0.05)。术后12个月时两组改良BADL评分比较无显著统计学差异(p>0.05)。结论 加速康复方案在老年转子间骨折中的应用是安全有效的,可以减少围手术期出血量,降低并发症发生,缩短住院时间,加快髋关节功能的恢复。 |
【关键词】加速康复 转子间骨折 骨质疏松 围手术期 |
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Enhanced recovery after surgery protocol in the elderly with femoral intertrochanteric fracture |
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ABSTRACT [Objective] the clinical effects of enhanced recovery after surgery (ERAS) in hip and knee replacement have been confirmed. This article aims to evaluate the clinical effects of the ERAS in the treatment of elderly patients with intertrochanteric fractures. [Methods] From January 2016 to October 2018, 80 elderly patients with intertrochanteric fractures were randomly divided into ERAS group and traditional rehabilitation group according to the treatment plan. Each group had 40 patients, and the ERAS consisted of 22 males and 18 females,aged 65-91 years, with an average of 78.6 years. In the traditional rehabilitation group, there were 19 males and 21 females, aged 65-91 years, with an average of 80.6 years old. The perioperative blood loss, complication rate, admission to surgery time, hospital stay, hip Harris score, and modified BADL scale were compared between the two groups. [Results] There were no incision healing events occured in the two groups. No complications such as wound infection, deep vein thrombosis and pulmonary embolism occurred during the follow-up period. 80 patients were followed up for more than 12 months, and the average follow-up time was (15.4±2.6) months. The total blood loss during the perioperative period of the ERAS group was significantly lower than that of the traditional rehabilitation group, and the difference was statistically significant (P<0.001). Although the incidence of complications in the ERAS group was lower than that in the traditional rehabilitation group, there was no significant difference between the two groups (p>0.05).Time from admission to initiation of surgery of the ERAS group was (1.48±0.51) days, and that of the traditional rehabilitation group was (4.35±1.55) days. There was a statistically significant difference between the two groups (t=11.185, p<0.01). The hospital stay of the ERAS group was (6.4 ± 1.1) days, and that of the traditional rehabilitation group was (9.9 ± 1.9) days. There was a statistically significant difference between the two groups (t = 9.958, p < 0.01). There was no significant difference in hip Harris score between the two groups at 12 months after surgery (p>0.05). There was no significant difference in the modified BADL score between the two groups at 12 months after surgery (p>0.05). [Conclusion] ERAS is safe and effective in the treatment of intertrochanteric fractures in the elderly. It can reduce perioperative bleeding volume and complications rate, shorten hospitalization time, and accelerate the recovery of hip function. |
KEY WORDS enhanced recovery after surgery, femoral intertrochanteric fracture, Osteoporosis, perioperative |
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