高龄髋部骨折患者围手术期的治疗分析

Perioperative Management of Elderly Patients with Hip Fracture

目的探讨高龄髋部骨折患者围手术期的治疗原则和特点。方法自2003年1月-2008年6月，对186例髋部骨折的高龄患者（年龄75岁以上）的合并症、术前准备、手术适应证与内固定的选择、以及术后处理进行回顾性分析。结果术后随访178例，本组病人除2例由于并发多种疾病死亡，其余病人均恢复生活自理能力，根据患者骨折愈合、关节活动、主观感觉与生活能力恢复等因素评定疗效，优良率为83．3％。结论针对不同的病人，可靠准确的术前全身状况评估、积极充分的术前准备、内固定器械和术式的选择、术后的合理用药和功能锻炼是高龄患者髋部骨折围手术期处理的重要内容，是减少手术并发症、提高手术疗效的关键。

Objective To explore the principles and methods of perioperative management of elderly patients with hip fracture. Methods A retrospective analysis was performed in 186 elderly patients with hip fracture. The complications ,preoperative preparation, operative indica- tions,internal fixation devices and postoperative management were reviewed. Results One hundred and Seventy-eight eases were followedup. The treatment effect was evaluated by fracture healing,joint motion,patient selfevaluation and activities of daily living,and the excellent or good recovery was found in 35 eases（83.3%）. No operationcansed deterioration of complications was found. Conclusion The perioperative management should include accurate evaluation of general condition, sufficient preoperative preparation, appropriate choice of internal fixation devices and operation procedure, reasonable medication and functional training after operation, all of which are the key to diminishing the risks for postoperative complications and to improving the surgery success of hip fracture in elderly patients.