多学科协作联合快速康复外科在老年髋部骨折患者中的应用效果  

Application effect of multidisciplinary team combined with enhanced recovery after surgery in 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(Osteology Department,Chengde Central Hospital,Chengde 067000,China)

机构地区：[1]承德市中心医院骨科,河北承德067000

出　　处：《临床医学研究与实践》2023年第22期65-68,共4页Clinical Research and Practice

基　　金：2020年承德市科学技术研究与发展计划项目(No.202006A019)。

摘　　要：目的探讨多学科协作(MDT)联合快速康复外科(ERAS)在老年髋部骨折患者中的应用效果。方法选取2019年12月至2020年11月承德市中心医院收治的110例老年髋部骨折患者为对照组,选取2020年12月至2021年11月承德市中心医院收治的120例老年髋部骨折患者为观察组。对照组实施常规处理,观察组实施MDT联合ERAS。比较两组的术前等待时间、术后进食时间、术后下床时间、住院天数、髋关节功能、日常生活活动能力及呼吸、泌尿、心血管、脑血管系统并发症发生情况和下肢深静脉血栓、谵妄发生情况。结果观察组的术前等待时间、术后进食时间、术后下床时间以及住院天数显著短于对照组,差异具有统计学意义(P<0.05)。出院前、出院后3个月,观察组的Harris、日常生活活动能力(ADL)评分显著高于对照组,差异具有统计学意义(P<0.05)。观察组的呼吸系统、泌尿系统并发症发生率及下肢深静脉血栓、谵妄发生率显著低于对照组,差异具有统计学意义(P<0.05);两组的心血管系统、脑血管系统并发症发生率比较,差异无统计学意义(P>0.05)。结论MDT联合ERAS可缩短老年髋部骨折患者术前等待时间、术后进食时间、术后下床时间以及住院天数,改善髋关节功能,提高生活自理能力,减少并发症的发生,值得临床进一步推广和应用。Objective To explore the application effect of multidisciplinary team(MDT)combined with enhanced recovery after surgery(ERAS)in elderly patients with hip fracture.Methods A total of 110 elderly patients with hip fracture admitted in Chengde Central Hospital from December 2019 to November 2020 were selected as control group,and 120 elderly patients with hip fracture admitted in Chengde Central Hospital from December 2020 to November 2021 were selected as observation group.The control group received routine treatment,and the observation group received MDT combined with ERAS.The preoperative waiting time,postoperative feeding time,postoperative off-bed time,hospital stay,hip function,activities of daily living,occurrence of respiratory,urinary,cardiovascular and cerebrovascular complications,lower extremity deep venous thrombosis and delirium were compared between the two groups.Results The preoperative waiting time,postoperative feeding time,postoperative off-bed time and hospital stay of the observation group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05).Before discharge and 3 months after discharge,the Harris and Activities of Daily Living(ADL)scores of the observation group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).The incidences of respiratory and urinary system complications,lower extremity deep venous thrombosis and delirium in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05);there were no significant differences in the incidences of cardiovascular and cerebrovascular system complications between the two groups(P>0.05).Conclusion MDT combined with ERAS can shorten the preoperative waiting time,postoperative feeding time,postoperative off-bed time and hospital stay,ameliorate the hip function,improve the self-care ability,and reduce the complications in elderly patients with hip

关 键 词：多学科协作 快速康复外科 髋部骨折 

分 类 号：R687.3[医药卫生—骨科学]