老年人髋部骨折的围手术期治疗

Perioperative treatment for hip fracture in elderly patients

目的探讨老年人髋部骨折的围手术期治疗。方法回顾性分析老年人髋部骨折手术治疗156例的临床资料。结果本组术前有82.1%(128/156)患者有内科合并疾病,全部患者均安全度过手术期,术后并发症共32例,发生率为20.5%。术前有无并存病与并发症的发生有直接关系(χ2=6.0069,P=0.0142)。手术治疗总优良率85.3%,术前没有并存病患者的手术优良率明显高于有并存病患者(P<0.01)。结论老年人髋部骨折患者术前合并疾病较多,视患者个体情况,采取积极恰当的围手术期处理,可降低围手术期并发症的发生率,取得优良的治疗效果。

Objective To investigate the perioperative treatment for hip fracture in elderly patients. Methods Clinical data of 156 elderly patients with hip fracture were analyzed retrospectively. Results The percentage of cases with concomitant diseases was 82. 1% （ 128 /156）. All patients passed the perioperative period safely. Postoperation complications occurred in 32 cases,with an incidence rate of 20. 5% ,and the good and excellent operation rate accounted for 85. 3%. Concomitant diseases was associated with the incidence of complications （ χ2 = 6. 0069,P = 0. 0142）. The good and excellent operation rate of without concomitant diseases patients was significant higher than that with concomitant diseases patients（ P 0. 01）. Conclusion Most elderly patients have different concomitant diseases. By applying proper perioperative management according to the conditions of the patient,decrease in the incidence of perioperative complications and increase in qualified surgical outcomes can be obtained.