多学科协作诊治模式下的营养干预在老年骨折患者围术期的应用

Application of nutritional intervention under multi-disciplinary team mode in perioperative period of elderly patients with fracture

目的研究多学科协作诊治模式(MDT)下的营养干预对围术期老年骨折患者的干预效果。方法选取新疆维吾尔自治区人民医院骨科2018年9月至2019年9月收治的42例行常规治疗的围术期老年患者作为非MDT组,选取同期43例实施MDT模式并给予营养干预的围术期老年患者作为MDT组,比较两组患者术后基本情况、并发症发生情况及恢复情况。结果术后MDT组患者总蛋白、白蛋白水平均高于非MDT组,NRS2002评分、CRP、IL-6水平均低于非MDT组,差异均有统计学意义(t=-3.6796、-4.1388、9.0733、-6.6695、-4.5002,P=0.0004、0.0001、<0.0001、<0.0001、<0.0001)。MDT组患者住院时间少于非MDT组,差异有统计学意义(髋关节置换术:t=2.1548,P=0.0341;膝关节置换术:t=2.4919,P=0.0189)。MDT组患者肠道功能恢复情况明显优于非MDT组,差异有统计学意义(χ^2=10.5121,P=0.0012)。结论MDT模式下的营养干预能够有效促进老年骨折患者的术后康复,有利于预防并发症的发生。

Objective To study the intervention effect of nutritional intervention under multi-disciplinary team(MDT)mode on elderly patients with fracture in perioperative period.Methods A total of 85perioperative patients who underwent orthopedic surgery in the People′s Hospital of Xinjiang Uygur Autonomous Region from September 2018to September 2019were enrolled.MDT group(43cases)were given nutritional intervention under MDT,while non-MDT group(42cases)were given the conventional intervention.The basic condition,postoperative complications and recovery of patients were compared between groups.Results The total levels of protein and albumin in the MDT group were higher than those in the non-MDT group,while the NRS2002 score,CPR and IL-6were lower than those in the non-MDT group;the differences were statistically significant(t=-3.6796,-4.1388,9.0733,-6.6695,-4.5002;P=0.0004,0.0001,<0.0001,<0.0001,<0.0001).The length of hospital stay in the MDT group was shorter than that in the non-MDT group,with statistically significant difference(hip replacement:t=2.1548,P=0.0341;knee arthroplasty:t=2.4919,P=0.0189).The recovery of intestinal function in the MDT group was significantly better than that in the non-MDT group(χ^2=10.5121,P=0.0012).Conclusion Nutritional intervention under MDT mode can effectively promote postoperative rehabilitation of elderly patients with fracture,reduce the incidence of infection and length of hospital stay,and prevent the occurrence of complications.