日间手术模式与普通住院手术模式治疗老年股骨转子间骨折的临床疗效分析

Clinical effect comparison between day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly

目的比较日间手术模式和普通住院手术模式治疗老年股骨转子间骨折的临床疗效。方法回顾性选取2018年7月-2019年7月在山西医科大学第二医院行日间手术模式治疗的老年股骨转子间骨折患者37例,同时随机选取同时期该院按普通住院手术模式治疗的老年股骨转子间骨折患者37例。分析比较两组患者的术前等待时间、手术时间、住院时间、住院费用、术后并发症、临床疗效等相关指标。结果两种手术模式治疗老年股骨转子间骨折在手术时间[(56.21±10.75)vs.(58.81±12.56)min]、术后髋关节Harris评分[术后1个月:(61.03±7.74)vs.(59.47±7.42)分;术后3个月:(85.40±4.22)vs.(85.03±4.33)分]方面差异无统计学意义(P>0.05),但行日间手术模式治疗的患者在术前等待时间[(23.17±3.18)vs.(52.64±10.12)h]、住院时间[(2.01±0.97)vs.(8.34±4.22)d]、住院费用[(4.012±0.771)万vs.(4.679±1.117)万元]以及围手术期下肢深静脉血栓形成发生率(10.8%vs.37.8%)等方面较普通住院手术模式治疗的患者有明显优势(P<0.05)。结论日间手术模式治疗老年股骨转子间骨折是安全、有效的,值得在今后临床工作中大力推广应用。

Objective To compare the clinical effect of day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly patients.Methods Thirty-seven elderly patients with intertrochanteric fracture treated in day surgery mode in the Second Hospital of Shanxi Medical University from July 2018 to July 2019 were retrospectively included.At the same time,another 37 elderly patients with intertrochanteric fracture treated in general inpatient operation mode in the same period were randomly selected.The preoperative waiting time,operation time,length of hospital stay,hospital expenses,postoperative complications,and clinical effect were compared between the two groups.Results There was no significant difference in operation time[(56.21±10.75)vs.(58.81±12.56)min]or postoperative Harris hip scores(1 month after surgery:61.03±7.74 vs.59.47±7.42;3 months after surgery:85.40±4.22 vs.85.03±4.33)between the two groups(P>0.05).In terms of the preoperative waiting time[(23.17±3.18)vs.(52.64±10.12)h],length of hospital stay[(2.01±0.97)vs.(8.34±4.22)d],hospital expenses[(4.012±0.771)×10^4 vs.(4.679±1.117)×10^4 yuan],and the incidence of deep venous thrombosis during perioperative period(10.8%vs.37.8%),the day surgery mode group had more obvious advantages than general inpatient operation mode group(P<0.05).Conclusions Day surgery mode is safe and effective for intertrochanteric fracture in elderly patients.It is worthy of great application for clinical work in the future.