加速康复外科理念下多学科共管模式在急诊老年髋部骨折围手术期中的应用  

Application of multidisciplinary team pattern of ERAS in perioperative nursing for the emergency elderly patients with hip fracture

作　　者：李嫚[1] 田蓓[1] 王爱丽[1] 李东红[1] 李忠哲[1] Li Man;Tian Pei;Wang Aili;Li Donghong;Li Zhongzhe(Operation Room,Beijing Jishuitan Hospital,Beijing,100035,China)

机构地区：[1]北京积水潭医院手术室,北京100035

出　　处：《现代临床护理》2020年第5期42-47,共6页Modern Clinical Nursing

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念下多学科共管模式在急诊老年髋部骨折围手术期护理中的应用效果,以期提高老年髋部骨折的治疗效果。方法采用不同病例前-后对照研究方法,将2015年5月—2017年2月在本院急诊住院手术的375例老年髋部骨折患者设为对照组,采用围手术期常规治疗护理;将2017年3月—2018年10月在本院急诊住院手术的401例老年髋部骨折患者设为试验组,采用ERAS理念下多学科共管模式治疗护理程式。比较两组患者入院至手术的时间,48h内手术的比例,术后并发症发生率,总住院时间和围手术期死亡率。结果两组患者入院至手术的时间,48h内手术的比例,术后并发症发生率,总住院时间和围手术期死亡率比较,均P<0.05,差异具有统计学意义,试验组患者入院到手术的时间短于对照组,48h内手术率高于对照组,术后并发症发生率与围手术期死亡率低于对照组。结论急诊老年髋部骨折患者采用ERAS理念下多学科共管模式治疗护理,可提高48h手术率,降低术后并发症发生率,缩短住院时间及降低围手术期死亡率。Objective To investigate the effect of multidisciplinary team pattern of ERAS in perioperative nursing for the emergency elderly patients with hip fracture so as to improve the treatment efficiency.Methods A group of 375 patients with hip fracture during May 2015 to February 2017 were assigned as the control group,where conventional nursing was done.Another group of 401 patients with hip fracture during March 2017 to October 2018 were assigned as the trial group, where the multidisciplinary team pattern of ERAS was used. The two groups were compared from the time from inpatient to operation, hospital stay and rate of perioperative complication and perioperative death. Results The rate of operation within 48 hours in the trial group was significantly higher than that of the control group (P<0.05). The hospital stay in the trial group was significantly shorter than that of the control group (P<0.05) and the rate of perioperative complication in the trial group were significantly lower than that of the control group (P<0.05) and the rate of perioperative death in the trial group was significantly lower than those of the control group. Conclusion The multidisciplinary team pattern of ERAS in perioperative nursing for the elderly patients with hip fracture can shorten the time of operation within 48 hours and hospital stay, and reduce the rates of perioperative complication and perioperative death.

关 键 词：加速康复外科 多学科共管模式 髋部骨折 不同病例前-后对照研究方法 老年人 急诊 

分 类 号：R473.6[医药卫生—护理学]