围术期加速康复外科模式对超高龄患者股骨颈骨折预后的效果

Effect of enhanced recovery after surgery model for on prognosis of elderly patients with femoral neck fracture during perioperative period

  • 摘要:
      目的  分析围术期加速康复外科(ERAS)模式对超高龄患者应用人工股骨头置换术治疗股骨颈骨折预后的效果。
      方法  选取行人工股骨头置换术治疗股骨颈骨折的超高龄患者118例为研究对象,随机分为对照组(n=59)和试验组(n=59)。对照组进行常规手术评估及术前准备,试验组围术期以ERAS模式干预。比较2组围术期相关指标及术后并发症发生情况。采用视觉模拟评分法(VAS)、Harris髋关节功能评分及欧洲五维健康量表(EQ-5D)评估患者疼痛程度和术后1、3个月髋关节功能及生活质量。
      结果  试验组患者48 h内手术率高于对照组,输血率、住院费用低于对照组,术后进食时间、离床活动时间、住院时间短于对照组,差异有统计学意义(P < 0.05)。术后3 d,试验组VAS评分低于对照组,差异有统计学意义(P < 0.05);术后1个月,试验组Harris评分高于对照组,差异有统计学意义(P < 0.05)。试验组并发症总发生率低于对照组,差异有统计学意义(P < 0.05)。
      结论  ERAS模式应用于超高龄患者股骨颈骨折人工股骨头置换术效果较好,可降低术后并发症发生率,有效促进患者术后恢复。

     

    Abstract:
      Objective  To analyze the effect of enhanced recovery after surgery (ERAS) model on prognosis of elderly patients with femoral neck fracture undergoing artificial femoral head replacement during perioperative period.
      Methods  A total of 118 elderly patients who underwent artificial femoral head replacement for femoral neck fracture were selected as research objects. They were randomly divided into control group (n=59) and experimental group (n=59). Routine surgical evaluation and preoperative preparation were performed in the control group, while ERAS mode intervention was performed in the experimental group during perioperative period. Perioperative indicators and postoperative complications were compared between the two groups. Visual Analogue Scale (VAS), Harris Hip Function Scale and European Five-dimension Health Scale (EQ-5D) were used to evaluate the pain degree, hip function at 1 month and 3 months after operation as well as quality of life.
      Results  The operation rate within 48 h in the experimental group was significantly higher, the blood transfusion rate and hospitalization cost were significantly lower, and the postoperative feeding time, bed-free activity time and hospitalization time were significantly shorter than those in the control group (P < 0.05). Three days after surgery, VAS score of the experimental group was significantly lower than that of the control group (P < 0.05). One month after surgery, Harris score of the experimental group was significantly higher than that of the control group (P < 0.05). The total incidence of complications in the experimental group was significantly lower than that in the control group (P < 0.05).
      Conclusion  ERAS model has a good effect in artificial femoral head replacement for elderly patients with femoral neck fracture, which can reduce the incidence of postoperative complications and effectively promote postoperative recovery of patients.

     

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