老年股骨粗隆间骨折围术期风险评估策略  

Perioperative Risk Assessment Strategy for Elderly Femoral Intertrochanteric Fractures

作　　者：王志明[1] 陈德元[1] 刘永恒[1] 吴俊哲[1] WANG Zhiming;CHEN Deyuan;LIU Yongheng;WU Junzhe(Department of Orthopedics,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan,Guangdong Province,528400 China)

机构地区：[1]中山市中医院骨一科,广东中山528400

出　　处：《中外医疗》2021年第12期4-7,共4页China & Foreign Medical Treatment

基　　金：2018年度中山市社会公益科技研究项目(2018B1101)。

摘　　要：目的对老年股骨粗隆间骨折患者围术期风险评估策略、管控措施进行探析。方法方便抽取该院180例就诊的股骨粗隆间骨折老年患者(年龄≥65岁)为研究对象,时间为2018年7月—2019年6月,将实施围术期风险评估与管控措施[生理学和手术严重度评分检点并发症和死亡率(POSSUM)评分系统及多学科协作]90例患者作为研究组,同期未采用POSSUM评分及多学科协作的90例患者作为对照组,比较两组患者术前等待时间、术后并发症及住院期间死亡率。结果研究组和对照组在性别、术前并发症、骨折类型方面比较,差异无统计学意义(P>0.05);研究组术前等待时间明显短于对照组[(3.30±1.01)d vs(7.30±1.12)d],差异有统计学意义(t=25.162,P<0.001)。研究组住院期间并发症总发生率较对照组低(21.11%vs 52.22%),差异有统计学意义(χ^(2)=18.756,P=0.001)。但两组住院期间病死率(0.00%vs 1.11%),差异无统计学意义(χ^(2)=0.000,P=1.000)。结论应用POSSUM评分及多学科协作策略评估老年股骨粗隆间骨折患者实施围术期风险并进行风险管控,可缩短术前等待时间,减少并发症,对患者病情恢复起到促进效果,值得临床推广应用。Objective To explore the perioperative risk assessment strategies and control measures for elderly patients with femoral intertrochanteric fractures.Methods 180 elderly patients(age≥65 years)with femoral intertrochanteric fractures in the hospital were convenient selected as the research object,from July 2018 to June 2019.Perioperative risk assessment and control measures[Physlological and operative severity score for enumeration of mortality and morbidity(POSSUM)scoring system and multidisciplinary collaboration]would be implemented in 90 patients as the research group,and 90 patients who did not use the POSSUM score and multidisciplinary collaboration as the control group during the same period.The preoperative waiting time,postoperative complications and mortality during hospitalization were compared between the two groups.Results There was no statistically significant difference between the two groups in terms of gender,preoperative complications,fracture type between the study group and control group(P>0.05);the preoperative waiting time in the study group was significantly shorter than the control group[(3.30±1.01)d vs(7.30±1.12)d],the difference was statistically significant(t=25.162,P<0.001).The total incidence of complications during hospitalization in the study group was lower than that in the control group(21.11%vs 52.22%),the difference was statistically significant(χ^(2)=18.756,P=0.001).However,there was no statistically significant difference in the mortality during hospitalization between the two groups(0.00%vs 1.11%)(χ^(2)=1.000,P=1.000).Conclusion The application of POSSUM score and multidisciplinary collaboration strategy to assess the perioperative risk of elderly patients with femoral intertrochanteric fractures and conduct risk management can shorten the preoperative waiting time,reduce complications,and promote the recovery of the patient’s condition.It is worthy of clinical practice,promotion and applications.

关 键 词：老年 股骨粗隆间骨折 围术期 风险评估 POSSUM评分 多学科协作 

分 类 号：R5[医药卫生—内科学]