多学科协作诊治模式在老年髋部骨折合并肾功能衰竭透析患者髋关节置换治疗中的应用  

Multidisciplinary team co-management in hip replacement treatment for elderly patients with hip fractures and renal failure undergoing dialysis

作　　者：彭晨健 张伟[1] 陈烁 赵建宁[1] 王军[1] Peng Chenjian;Zhang Wei;Chen Shuo;Zhao Jianning;Wang Jun(Department of Bone Traumatology,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210003,China)

机构地区：[1]南京中医药大学附属南京中医院骨伤科,210003

出　　处：《中华老年病研究电子杂志》2023年第2期19-23,共5页Chinese Journal of Geriatrics Research(Electronic Edition)

摘　　要：目的观察多学科协作诊治模式在老年髋部骨折合并肾功能衰竭透析患者髋关节置换治疗中的应用效果。方法选取2016年8月至2021年8月在南京中医药大学附属南京中医院接受髋关节置换治疗的髋部骨折合并肾功能衰竭需要血液透析的62例老年患者,其中30例采取常规诊治模式(常规治疗组),32例采取多学科协作诊治模式(协作治疗组)。比较两组患者的术前住院时间、手术时间、术后下地时间、住院总时间、Harris评分、功能独立性检查量表(FIM)评分以及术后并发症的发生情况。计量资料的比较采用t检验和重复测量方差分析,计数资料的比较采用χ^(2)检验。结果与常规治疗组比较,协作治疗组术前住院时间、术后下地时间和住院总时间均显著缩短(t=4.203、10.052、4.295,P<0.01)。术后Harris评分及FIM评分的比较,差异均无组间效应(F=1.125、3.146,P>0.05)。术后1个月和1年,协作治疗组并发症发生数量均少于常规治疗组(Z=-1.980、2.890,P<0.05)。结论对于老年髋部骨折合并肾功能衰竭的透析患者,在髋关节置换治疗中采取多学科协作诊治模式,可以加速患者术后功能的恢复,提升生活质量。Objective To observe the clinical efficacy of multidisciplinary team(MDT)comanagement in hip replacement treatment for elderly patients with hip fractures and renal failure undergoing dialysis.Methods A total of 62 elderly patients with hip fractures and renal failure require hemodialysis who underwent hip replacement treatment in Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from August 2016 to August 2021 were selected.Among them,30 patients received conventional treatment mode(routine group)and 32 patients received multidisciplinary collaborative treatment mode(cooperative group).The preoperative hospitalization time,operation time,postoperative time to the ground,total hospitalization time,Harris score,Functional Independence Scale(FEM)score,and postoperative complications were compared between the two groups.T test and repeated measurement analysis of variance were used for comparison of measurement data,and χ^(2) test was used for comparison of counting data.Results Compared with the routine group,the preoperative hospitalization time,postoperative ground time,and total hospitalization time were shortened in the cooperative group(t=4.203,10.052,4.295;P<0.01).There was no difference between the two groups in postoperative Harris score and FIM score(F=1.125,3.146;P>0.05).One month and one year after surgery,the number of complications in the collaborative group decreased compared with the routine group(Z=-1.980,2.890;P<0.05).Conclusion MDT co-management can accelerate postoperative functional recovery,and improve quality of life in elderly hip fracture patients with renal failure undergoing joint replacement treatment.

关 键 词：多学科协作 老年人 髋部骨折 肾功能衰竭 血液透析 髋关节置换 

分 类 号：R683.4[医药卫生—骨科学]