多学科会诊与老年病专科会诊对老年髋部骨折手术预后的影响  

Comparative study on intervention efficacy between multidisciplinary and geriatric specialist on prognosis in elderly patients with hip fractures

作　　者：徐勇强[1] 秦梅兰[1] 许自力[1] 贾真[1] 冯嗣寅[1] 黄焱[1] 康亦锋[1] XU Yong-qiang;QIN Mei-lan;XU Zi-li;JIA Zhen;FENG Si-yin;HUANG Yan;KANG Yi-feng(Department of Orthopedics,Hunan Provincial People's Hospital,Changsha,Hunan 410005,China)

机构地区：[1]湖南省人民医院骨科,湖南长沙410005

出　　处：《中国骨与关节损伤杂志》2018年第12期1236-1239,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨多学科会诊模式与老年病专科会诊模式对老年髋部骨折患者手术预后的影响。方法回顾性分析自2015-03—2017-03行手术治疗的136例老年髋部骨折,自2015-03—2016-03诊治的64例围手术期进行多学科会诊(对照组),自2016-04—2017-03诊治的72例围手术期进行老年病专科会诊(观察组)。比较2组会诊次数、术前等待时间、住院时间、术后谵妄识别率、术后并发症发生率,以及术后3、6、12个月生存率。结果与对照组比较,观察组会诊次数明显更少,术前等待时间及住院时间明显更短,术后谵妄识别率更高,并发症发生率更低,差异有统计学意义(P <0.05)。存活的患者术后随访时间为1～2年。术后3、6个月时,观察组与对照组存活率差异无统计学意义(P>0.05);术后12个月时,观察组存活率高于对照组,差异有统计学意义(P <0.05)。结论对老年髋部骨折手术患者采用老年病专科会诊模式进行诊治,能给出及时而又高质量的会诊意见,可以缩短术前等待时间和住院时间,降低并发症发生率,提高患者的生存率及生存质量。Objective To explore the efficacy of multidisciplinary consultation mode and geriatric specialist consultation mode on the surgical prognosis of elderly hip fracture patients.Methods A retrospective analysis of 136 elderly hip fractures treated surgically from March 2015 to March 2017 was conducted.Sixty four cases received perioperative multidisciplinary consultation (control group) treated from March 2015 to March 2016 while 72 patients received geriatric specialist consultation (observation group) treated from April 2016 to March 2017.The times of consultation,the waiting time before operation,the length of hospital stay,the incidence of postoperative delirium,the incidence of postoperative complications and the survival rate of 3,6 and 12 months after operation were compared between the two groups.Results Compared with the control group,the observation group had significantly fewer consultation times,significantly shorter waiting time before operation and hospitalization time,higher recognition rate of postoperative delirium and lower incidence of complications,with statistically significant difference (P <0.05).The survival patients were followed up for 1-2 years.At 3 and 6 months after operation,there was no significant difference in survival rate between the observation group and the control group (P >0.05).At the 12th month after operation,the survival rate of the observation group was higher than that of the control group,the difference was statistically significant (P <0.05).Conclusion The intervention of geriatric specialist consultation mode for elderly hip fracture patients can give timely and high-quality consultation advice,shorten preoperative waiting time and hospitalization time,reduce the incidence of complications,and improve the survival rate and quality of life of patients.

关 键 词：髋部骨折 股骨颈骨折 股骨粗隆间骨折 老年病专科会诊模式 多学科会诊模式 谵妄 

分 类 号：R687.3[医药卫生—骨科学]