加速康复外科理念在老年转子间骨折围术期中的应用  

Application of enhanced recovery after surgery in the perioperative period of femoral intertrochanteric fractures in elderly patients

作　　者：王维[1] 杨军[1] 张欣[1] 刘忠鑫 王湛[1] 丁立峰[1] Wang Wei;Yang Jun;Zhang Xin;Liu Zhongxin;Wang Zhan;Ding Lifeng(Department of Orthopedics ,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院骨科,沈阳110004

出　　处：《中华老年医学杂志》2018年第12期1340-1342,共3页Chinese Journal of Geriatrics

摘　　要：目的 加速康复外科理念(ERAS)在老年转子间骨折围术期中的应用价值. 方法回顾性分析沈阳盛京医院2014年1月至2017年1月收治的100例老年股骨转子间骨折患者,根据其治疗方式分为ERAS组和常规组各50例,比较两组的住院时间、术后疼痛视觉模拟评分(VAS)、并发症发生率、手术时间、髋关节功能 Harris评分等. 结果 100例患者获得20个月(平均18.7个月)的随访,ERAS组住院时间(6.06 ± 1.89) d较常规组(8.02 ± 1.89) d少(P<0.05) ;ERAS组、常规组VAS评分分别为(3.02 ± 1.79)分、(3.66 ± 1.06)分(均 P<0.05) ;两组并发症发生率(谵妄、泌尿系感染)比较差异有统计学意义(均 P<0.05) ,手术时间、术后1年髋关节功能 Harris评分比较差异无统计学意义(P>0.05) . 结论 应用ERAS理念治疗老年转子间骨折,能显著减少患者住院时间,减轻患者术后疼痛,减少术后并发症的发生,值得推广应用.Objective To investigate the value of enhanced recovery after surgery(ERAS)in the perioperative period of intertrochanteric femoral fractures in elderly patients.Methods A retrospective analysis of 100elderly patients with intertrochanteric femoral fractures at Shenyang Shengjing Hospital from January 2014to January 2017was conducted.According to the treatment, patients were divided into two groups.,an ERAS group and a routine group (n=50,each). Hospitalization times,postoperative pain visual analogue scales(VAS),complication rates,operation times,evaluated byHarris hip scores and other parameters were compared between the two groups. Results All patients were followed up for 20months(mean=18.7months).The hospitalization time and postoperative pain VAS score were shorter or lower in the ERAS group than in the routine group [(6.06±1.89)d vs.(8.02±1.89)d,3.02±1.79vs.3.66±1.06,both P<0.05].There was a significant difference in rates of complications(delirium and urinary tract infection)between the groups (P<0.05).There was no statistically significant difference in operation time or Harris hip score between the groups one year after surgery (both P>0.05).Conclusions ERAS in treating intertrochanteric femoral fractures in the elderly can significantly reduce the length of hospital stay, postoperative pain and complications,and should be recommended.

关 键 词：康复 髋骨折 围手术期 

分 类 号：R687.3[医药卫生—骨科学]