急诊模式下ERAS在老年股骨转子间骨折围手术期中的应用  

作　　者：张彬 张一[1] 佘荣峰[1] 张磊冰[1] 常亮[1] 

机构地区：[1]贵州省人民医院,550002

出　　处：《浙江临床医学》2023年第8期1156-1158,共3页Zhejiang Clinical Medical Journal

基　　金：贵州省科技计划项目([2019]1210号)。

摘　　要：目的探讨急诊模式下加速康复外科(ERAS)理念在老年股骨转子间骨折围手术期治疗中的临床效果。方法回顾性分析本院2021年2月至2022年6月治疗的64例>65岁的股骨转子间骨折临床资料,根据处理方式不同,将其分为急诊ERAS组和常规组。急诊ERAS组患者共31例,平均79.3岁(65~89岁),按Evans分型,Ⅰ型3例,ⅡⅢ型10例,Ⅲ型12例,Ⅳ型6例;常规组患者共33例,平均78.2岁(65~88岁),按Evans分型,Ⅰ型4例,Ⅱ型11例,Ⅲ型13例,Ⅳ型5例。观察两组患者术前等待时间、手术时间、术中失血量、术后第1天疼痛视觉模拟评分(VAS评分)、术后住院时间,观察两组患者并发症的发生情况。结果所有患者临床资料均完整获得,所有患者伤口均愈合良好。术前两组患者年龄、男女比例等方面比较差异不具有统计学意义(P>0.05)。急诊ERAS组在术前等待时间、手术时间、术中失血量、术后第1天VAS评分、术后住院时间均明显低于常规组(P<0.05)。结论老年股骨转子间骨折患者通过急诊模式可缩短术前等待时间和住院时间,而快速康复外科理念的应用则使患者在围手术期获得更多益处。Objective To explore the application effect of enhanced recovery after surgery(ERAS)of emergency mode on elderly patients with intertrochanteric fractures during perioperative period.Methods 64 patients older than 65 years were treated for femoral intertrochanteric fracture and completed full follow-ups.The patients were divided into the emergency ERAS group and the regular group.The emergency ERAS group with an average age of 79.3 years.The regular group with an average age of 78.2 years.The waiting time before the operation,operation time,intraoperative blood loss,VAS score of the first day after the operation,postoperative hospital stay,postoperative complication incidence were observed.Results 64 patients were followed up successfully.The waiting time before the operation,operation time,intraoperative blood loss,VAS score of the first day after the operation and postoperative hospital stay days in emergency ERAS group were significantly lower than those in regular group.Conclusion The elderly patients with intertrochanteric fractures can efficiently shorten waiting time before operation and hospital stay by emergency mode,and application of ERAS make elderly patients get more benefits benefit.

关 键 词：老年人股骨骨折 快速康复外科 急诊处理 

分 类 号：R687.3[医药卫生—骨科学]