快速康复外科理论在老年桡骨远端骨折手术治疗中的应用  

Application of fast track surgery in surgical treatment of distal radius fractures in the elderly

作　　者：苏日宝 王培吉[1] 王秀会 崔满意[1] 赵家举[1] 周聚普[1] Su Ribao;Wang Peiji;Wang Xiuhui;Cui Manyi;Zhao Jiaju;Zhou Jupu(Department of Hand and Foot Surgery,the Second Hospital Affiliated to Suzhou University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院手足外科,苏州215004 [2]健康医学院附属周浦医院骨科,上海

出　　处：《中华手外科杂志》2018年第5期338-341,共4页Chinese Journal of Hand Surgery

基　　金：苏州市科技计划（民生科技）项目（SS201636）;上海市卫计委科研课题项目（201740306）;上海市医学重点专科项目（ZK2015A14）

摘　　要：目的探讨陕速康复外科理论在老年桡骨远端骨折内吲定手术治疗中的临床疗效。方法回顾性分析自2014年1月至2015年12月符合研究纳入标准行掌侧入路解剖型锁定钢板内固定治疗的老年桡骨远端骨折患者（年龄≥65岁）121例，应用快速康复外科理论治疗（A组）64例和常规治疗（B组）57例进行围手术期干预。比较两组患者围手术期的并发症、住院时间及腕关节功能，观察两组随访患者近期临床疗效。结果A组围手术期中枢神经系统疾病发生率、恶心呕吐发生率、术后48h的VAS评分及术后住院时间均低于B组（P=0．006，P=0．014，P=0．000，P=0．000）。术后12周A组患者腕关节Gartland—Werley功能评分明显优于B组。结论快速康复外科理论在老年桡骨远端骨折用手术期的应用，能促进早期康复，缩短住院时间，减少相关并发痱。Objective To investigate the clinical efficacy of fast track surgery in surgical treatment of internal fixation for the elderly patients with distal radius fractures. Methods From January 2014 to December 2015, 121 elderly patients （age ≥ 65 years） with distal radius fractures who treated with internal fixation by anatomic locking plate through volar approach were retrospectively analyzed. 64 cases were treated by fast track surgery （group A） and 57 cases received routine treatment during perioperative period （group B）. The perioperative complications, hospitalization time and wrist function of the two groups were compared, and the short-term clinical effects of the two groups were observed. Results In group A, the incidence of central nervous system disease, the incidence of nausea and vomiting, VAS score at 48 hours after the operation and the time of postoperative hospitalization were lower than those in group B （P=0.006, P=0.014, P=0.000, P=0.000）. At 12 weeks postoperatively, wrist Gartland-Werley score in group A was significantly better than that in group B. Conclusion The application of fast track surgery in the elderly with distal radius fractures can promote early rehabilitation, shorten hospitalization time and reduce related complications.

关 键 词：桡骨骨折 治疗结果 快速康复外科 老年 围手术期 

分 类 号：R687.3[医药卫生—骨科学]