多学科团队合作应用加速康复外科技术治疗老年患者髋部骨折  

Application of Multidisciplinary Teamwork Combined with Enhanced Recovery after Surgery in the Treatment of Hip Fractures in Elderly Patients

作　　者：于红伟[1] 张晋华[1] 林涛[1] 庞哲[1] Yu Hongwei;Zhang Jinhua;Lin Tao;Pang Zhe(Department of Orthopaedics,Fifth People’s Hospital of Datong,Datong 037006,China)

机构地区：[1]大同市第五人民医院骨科,山西大同037006

出　　处：《实用骨科杂志》2022年第8期702-705,711,共5页Journal of Practical Orthopaedics

基　　金：大同市重点研发计划项目(2019070)。

摘　　要：目的探讨多学科团队合作应用加速康复外科(enhanced recovery after surgery,ERAS)技术治疗老年患者髋部骨折的临床疗效。方法本研究收集2019年8月至2020年12月就诊于大同市第五人民医院股骨转子间骨折的患者100例,随机分为对照组(50例)和ERAS组(50例)。对照组男21例,女29例;年龄70~87岁,平均(73.0±10.7)岁;左侧27例,右侧23例;骨折分型:EvansⅠ型稳定型30例,EvansⅠ型不稳定型15例,EvansⅡ型5例。ERAS组男19例,女31例;年龄70~89岁,平均(75.0±11.2)岁;左侧21例,右侧29例;骨折分型:EvansⅠ型稳定型33例,EvansⅠ型不稳定型13例,EvansⅡ型4例。分别采用多学科团队合作ERAS治疗流程和传统常规治疗流程,比较两组患者在术前等待时间、平均住院日、住院费用、疼痛视觉模拟评分(visual analogue scale,VAS)、患者住院满意度评分、并发症的发生率和髋关节Harris评分。结果ERAS组术前住院时间、平均住院日、住院费用和术后并发症的发生率均低于对照组,患者的满意度评分和术后髋关节Harris评分均高于对照组,差异均有统计学意义(P<0.001)。两组患者术后第1天ERAS组VAS评分明显低于对照组(P<0.05),而术前和术后第5天的VAS评分比较差异无统计学意义(P>0.05)。结论应用多学科团队合作辅助ERAS技术治疗老年患者的髋部骨折,能够明显提高患者医疗质量和满意度,降低并发症发生,减少治疗费用。Objective To explore the clinical effect of multidisciplinary teamwork in the application of enhanced recevery after surgery in the treatment of hip fractures in elderly patients.Methods 100 patients with femoral intertrochanteric fracture treated in Datong Fifth People’s Hospital from August 2019 to December 2020 were randomly divided into control group(50 cases)and study group(50 cases).There were 21 males and 29 females in the control group.The average age was(73.0±10.7)years(range,70~87 years).27 left fracture and 23 right fracture were included.There were 30 cases of stable type EvansⅠ,15 cases of unstable type EvansⅠand 5 cases of type EvansⅡ.There were 19 males and 31 females in ERAS group.The average age was(75.0±11.2)years(range,70~89 years).There were 21 cases on the left and 29 cases on the right.There were 33 cases of stable type EvansⅠ,13 cases of unstable type EvansⅠ,and 4 cases of type EvansⅡ.Multidisciplinary teamwork ERAS treatment process and traditional conventional treatment process were used respectively.The preoperative waiting time,average hospital stay,hospitalization cost and visual analogue scale(VAS),inpatient satisfaction score,incidence of complications and the hip Harris scores.Results The preoperative hospital stay,average hospital stay,hospitalization expenses and the incidence of postoperative complications in ERAS group were lower than those in the control group.The satisfaction score and the hip Harris scores of postoperative in ERAS group were higher than those in the control group(P<0.001).The VAS score of pain in ERAS group was significantly lower than that in control group on the first day after operation(P<0.05),but there was no significant difference between the two groups before operation and on the fifth day(P>0.05).Conclusion The application of multi-disciplinary teamwork assisted enhanced recovery after surgery in the treatment of hip fractures in elderly patients can significantly improve the medical quality and satisfaction of patients,reduce the occu

关 键 词：髋部骨折 加速康复外科 多学科团队合作 

分 类 号：R683.3[医药卫生—骨科学]