加速康复外科理念结合多学科协作治疗模式对老年髋部骨折患者围手术期指标的影响  

Effect of enhanced recovery after surgery combined with multidisciplinary treatment mode on perioperative indexes of elderly patients with hip fracture

作　　者：朴海旺 张海亭 马青嵩 王荣升[1] 金宝城[1] 张威 PIAO Haiwang;ZHANG Haiting;MA Qingsong;WANG Rongsheng;JIN Baocheng;ZHANG Wei(Department of Orthopedics,Chengde Central Hospital,Hebei Province,Chengde 067000,China)

机构地区：[1]河北省承德市中心医院骨科,河北承德067000

出　　处：《中国当代医药》2023年第15期56-60,共5页China Modern Medicine

基　　金：河北省承德市科学技术研究与发展计划项目(202006A019)。

摘　　要：目的探讨加速康复外科(ERAS)理念结合多学科协作(MDT)治疗模式对老年髋部骨折患者围手术期指标的影响。方法选取2020年1月至12月承德市中心医院收治的70例老年髋部骨折患者作为对照组,2021年1月至12月承德市中心医院收治的75例老年髋部骨折患者作为观察组。对照组患者采用传统治疗模式,观察组患者采取ERAS理念结合MDT的治疗模式。比较两组患者的术前等待时间、术后进食时间、术后下床时间、住院时间、手术前后的视觉模拟评分法(VAS)评分、出院前及出院后3个月的髋关节Harris评分、患者住院满意度评分(PSQ)、术后肺炎、泌尿系感染、下肢深静脉血栓、谵妄、心脑血管意外并发症发生率及48 h内手术率。结果观察组患者的术前等待时间、术后进食时间、术后下床时间、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组患者手术前后的VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组患者出院前及出院后3个月的髋关节Harris评分、PSQ评分、48 h内手术率高于对照组,差异有统计学意义(P<0.05)。观察组患者的术后肺炎、泌尿系感染、下肢深静脉血栓发生率均低于对照组,差异有统计学意义(P<0.05);两组患者的心脑血管系统、谵妄发生率比较,差异无统计学意义(P>0.05)。结论ERAS理念结合MDT治疗模式能够缩短老年髋部骨折患者术前等待时间、术后进食时间、术后下床时间和住院时间,减少并发症,提高48 h内手术率及患者住院满意度,促进髋关节功能恢复。Objective To explore the effect of the enhanced recovery after surgery(ERAS)combined with multidisciplinary treatment(MDT)mode on the perioperative indexes of elderly patients with hip fracture.Methods A total of 70 elderly patients with hip fracture in Chengde Central Hospital from January to December 2020 were selected as the control group,and 75 elderly patients with hip fracture in Chengde Central Hospital from January to December 2021 were selected as the observation group.The control group adopted the traditional treatment mode.The observation group adopted the ERAS combined with MDT mode.The preoperative waiting time,postoperative food-taking time,the time to get out of bed after surgery,time of hospitalization,visual analogue scale(VAS)score before and after surgery,Harris score of hip joint before and 3 months after discharge,patient satisfaction questionnaire(PSQ)score,incidence of complications of postoperative pneumonia,urinary system infection,deep vein thrombosis of lower limbs,delirium,cardio-cerebrovascular accident and 48-hour operation rate were compared between the two groups.Results The preoperative waiting time,postoperative food-taking time,postoperative bedtime and hospitalization duration of patients in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).The VAS scores of the patients in the observation group before and after operation were lower than those in the control group,with statistically significant differences(P<0.05).The Harris score,PSQ score and 48-hour operation rate of the patients in the observation group before and 3 months after discharge were higher than those in the control group,with statistically significant differences(P<0.05).The incidence of postoperative pneumonia,urinary system infection and lower extremity deep vein thrombosis in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences be

关 键 词：加速康复外科 多学科协作 围手术期 老年髋部骨折 

分 类 号：R687.3[医药卫生—骨科学]