ERAS理念在骨质疏松性髋部骨折的应用  

作　　者：洪胜坤 王巍[1] 何飞熊[1] 谢俊[1] 郭金库 付志强 金乾坤[1] 

机构地区：[1]浙江省衢州市人民医院,324000

出　　处：《浙江临床医学》2022年第1期82-84,共3页Zhejiang Clinical Medical Journal

基　　金：衢州市指导性科技计划项目(2019066)。

摘　　要：目的探讨ERAS理念指导下骨质疏松性髋部骨折早期手术的疗效.方法骨质疏松性髋部骨折患者80例,分为早期手术组(采用ERAS理念伤后48h内手术)与延迟手术组(采用常规模式伤后48h后手术).比较两组患者术后并发症相关的血流动力学指标,评估患者术后精神状态和髋关节功能.结果与早期手术组比较,延迟手术组患者术后第1、3、7天血红蛋白含量明显降低(P<0.05),术后第1天延迟手术组红细胞压积升高(P<0.05),术后第3、7天红细胞压积降低,第3天降幅较大(P<0.05),术后第1天延迟手术组CRP较早期手术组升高(P<0.05),术后第3天延迟手术组血沉高于早期手术组(P<0.05),两组髋关节功能评分比较,差异无统计学意义(P>0.05).结论骨质疏松性髋部骨折患者应用ERAS理念指导围术期治疗的模式,优于常规模式,能够减少患者术后隐性出血及炎症反应的发生,减少住院时间,降低并发症发生率及有效改善机体疼痛,有利于术后快速康复,提高老年髋部骨折的生存率及生活质量.Objective To explore the effect of early surgery on osteoporotic hip fractures under the guidance of enhanced recovery after surgery(ERAS)concept.Methods 80 cases of osteoporotic hip fracture patients admitted to our hospital were divided into an early operation group(operation within 48 hours after injury)and a delayed operation group(operation after 48 hours after injury)according to the operation time under the guidance of the ERAS concept.Observe and compare the hemodynamic indexes related to postoperative complications of the two groups of patients,and evaluate the postoperative mental state and hip function of the patients.Results Compared with the early operation group,the hemoglobin content of the delayed operation group was significantly reduced on the first,third,and seventh day after surgery(P<0.05),and the hematocrit in the delayed operation group was increased(P<0.05),the hematocrit was decreased on the third and seventh days after surgery,and the decrease was slightly greater on the third day(P<0.05).The CRP in the delayed surgery group on the first day after surgery was significantly higher than that in the early surgery group(P<0.05),the erythrocyte sedimentation rate of the delayed operation group was significantly higher than that of the early operation group on the third day after operation(P<0.05).The hip function score of the early postoperative surgery group was slightly higher than that of the delayed surgery group,but there was no statistical significance between the two groups(P>0.05).Conclusion The application of the ERAS concept to guide the perioperative treatment of patients with osteoporotic hip fractures is better than conventional treatments,which can reduce the incidence of postoperative hidden bleeding and inflammatory reactions,significantly reduce the length of hospitalization,and reduce complications.It can effectively improve body pain,facilitate rapid postoperative recovery,and improve the survival rate and quality of life of elderly hip fractures.

关 键 词：ERAS 骨质疏松 髋部骨折 炎症反应 隐性失血 生活质量 

分 类 号：R68[医药卫生—骨科学]