中医特色的ERAS理念下多学科合作在高龄骨折患者围手术期的应用研究  

Application Research of Multidisciplinary Collaboration under the ERAS Concept with Traditional Chinese Medicine Characteristics in the Perioperative Period of Elderly Patients with Fractures

作　　者：段超 周细江 王艺 刘明 邓超 Duan Chao;Zhou Xijiang;Wang Yi;Liu Ming;Deng Chao(Changsha Hospital of Traditional Chinese Medicine,Changsha Eighth Hospital,Hunan,Changsha 410000,China)

机构地区：[1]湖南省长沙市中医医院,湖南省长沙市第八医院,湖南长沙410000

出　　处：《中国中医急症》2024年第9期1604-1607,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：湖南省卫健委重点课题项目(A20182009);湖南省卫生健康委课题项目(202304076698);湖南省中医药管理局青年课题项目(20200202)。

摘　　要：目的研究中医特色的快速康复外科(ERAS)理念下多学科合作在高龄骨折患者围手术期的应用。方法60例股骨粗隆间骨折患者按照随机数字表法分为两组,观察组在围手术期通过多学科合作模式,采用多项中医适宜技术联合中药内服调理干预,对照组采用常规方法治疗,干预结束后,从多项指标进行对比、评价。结果观察组患者的首次下床时间及住院时间均明显短于对照组(P<0.01);尿潴留、便秘、压疮、深静脉血栓、睡眠障碍等并发症发生情况比较,观察组发生率均明显少于对照组(P<0.05);在疼痛评分,HAMD、HAMA心理状态评分、Harris髋关节评分、骨折愈合X线评分方面比较,观察组患者均明显优于对照组(P<0.01)。结论中医特色的ERAS理念下多学科合作模式,内外兼治,可极大地促进高龄骨折患者快速康复。Objective:To study the application of multidisciplinary collaboration under the enhanced recovery after surgery(ERAS)concept with traditional Chinese medicine(TCM)characteristics in the perioperative period of elderly patients with fractures.Methods:60 patients with intertrochanteric femur fractures were divided into two groups using a random number table method.The observation group underwent multidisciplinary cooperation during the perioperative period,utilizing various appropriate TCM techniques combined with oral administration of TCM for intervention.The control group received conventional treatment.After the intervention,comparisons and evaluations were made across multiple indicators.Results:The time to first ambulation and length of hospital stay were significantly shorter in the observation group compared to the control group(P<0.01).In terms of common complications such as urinary retention,constipation,pressure ulcers,deep vein thrombosis,and sleep disorders,the incidence was significantly lower in the observation group compared with the control group(P<0.05).In terms of pain scores,Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA)psychological state scores,Harris hip scores,and fracture healing X-ray scores,the observation group had significantly better outcomes compared with the control group(P<0.01).Conclusion:The multidisciplinary cooperation model under the ERAS concept with TCM characteristics,combining internal and external treatments,can greatly promote the rapid recovery of elderly patients with fractures.

关 键 词：高龄骨折 围手术期 快速康复外科模式 中医特色 

分 类 号：R683.4[医药卫生—骨科学]