绿色通道对老年股骨粗隆部骨折的临床疗效  

Clinical effect of green channel in the treatment of elderly patients with femoral intertrochanteric fracture

作　　者：马壮 段宁 刘宏亮 薛汉中 路遥 杨娜 田丁 赵国龙 王鑫鑫 兰郎郎 张堃 Ma Zhuang;Duan Ning;Liu Hongliang;Xue Hanzhong;Lu Yao;Yang Na;Tian Ding;Zhao Guolong;Wang Xinxin;Lan Langlang;Zhang Kun(Department of Orthopedics and Traumatology, Honghui Hospital Affiliated to Medical Department of Xi'an Jiaotong University, Xi'an 710054, China)

机构地区：[1]西安交通大学医学部附属红会医院创伤骨科,710054 [2]延安大学 [3]陕西中医药大学医学系,712046

出　　处：《骨科临床与研究杂志》2022年第2期86-91,共6页Journal Of Clinical Orthopedics And Research

基　　金：西安市科技计划项目(2019115013YX005SF038-14)。

摘　　要：目的探究绿色通道下治疗老年股骨粗隆部骨折手术疗效及预后情况。方法2019年6月至2020年6月西安市红会医院创伤骨科下肢病区收治的股骨粗隆部骨折患者100例。其中2019年6月至2019年12月收治的股骨粗隆部骨折患者50例为常规组,予常规治疗;2020年1月至2020年6月收治的股骨粗隆部骨折患者50例为绿色通道组,予绿色通道流程。比较俩组患者术前一般资料情况和术中手术时间、术中出血量,以及术后并发症、髋关节功能Harris评分、生活质量评分等相关指标。结果两组患者均顺利完成手术。两组患者术前一般资料性别、年龄、骨折分型、合并内科疾病均无统计学意义(均P>0.05)。术中指标比较,绿色通道组手术时间较常规组短(P<0.001);绿色通道组术中出血量、术后一天引流量、隐性失血量少于常规组(P<0.001)。绿色通道组住院时间和术后卧床时间也比常规组短(均P<0.05)。绿色通道组无延迟愈合病例;常规组延迟愈合1例(P=0.044)。绿色通道组髋关节疼痛3例,常规组髋关节疼痛6例,差异有统计学意义(P=0.036)。绿色通道组压疮2例,常规组压疮5例(P=0.018)。绿色通道组切口感染1例,常规组切口感染3例,差异有统计学意义(P=0.041)。绿色通道组术后1、3、6个月髋关节功能Harris评分均高于常规组(均P<0.05)。绿色通道组术后6个月生理功能、躯体疼痛、活力、社会功能评分均高于常规组(均P<0.05)。术前髋关节功能Harris评分、术后静脉血栓发生率、内固定松动发生率、心肌梗死发生率、肺部感染发生率、生理职能评分、总体健康评分、情感职能评分、心理健康评分两组间差异均无统计学意义(均P>0.05)。结论绿色通道治疗老年股骨粗隆部骨折术后并发症少,术后康复快,术后生活质量高。Objective To explore the operative effect and prognosis of the treatment of senile trochanteric fracture in green channel.Methods A total of 100 patients with trochanteric fracture of femur admitted to the lower limb department of orthopedics and trauma department of Xi'an Honghui Hospital from June 2019 to June 2020 were selected as the research subjects.Fifty patients with trochanteric fracture of femur admitted to the lower limb department from June 2019 to December 2019 were selected as the routine group and received routine treatment;Fifty patients with trochanteric fracture of femur admitted from January 2020 to June 2020 were selected as the green channel group and came into the green channel.Preoperative general information,operative time,intraoperative blood loss,postoperative complications,Harris score of hip function,quality of life score and other related indexes were compared between the two groups.Results The operation was completed successfully in both groups.There was no statistical significance in preoperative general information of patients in both groups,such as gender,age,fracture type and complicated medical diseases(all P>0.05).Compared with the conventional group,the operative time of the green channel group was shorter(P<0.001).The amount of intraoperative blood loss,postoperative one-day drainage volume and latent blood loss in the green channel group were less than those in the conventional group(P<0.001).The hospitalization time and postoperative bed rest time of the green channel group were shorter than those of the conventional group(all P<0.05).There was no delayed healing in the green channel group and 1 case in the conventional group(P=0.044).There were 3 cases of hip pain in the green channel group and 6 cases in the conventional group(P=0.036).There were 2 cases of pressure sores in the green channel group and 5 cases in the conventional group(P=0.018).There was 1 case of incision infection in the green channel group and 3 cases in the conventional group(P=0.041).Harris score of

关 键 词：股骨骨折 术后并发症 老年人 绿色通道 

分 类 号：R68[医药卫生—骨科学]