加速康复外科在老年股骨粗隆间骨折治疗中的应用

Practice of Fast Track Surgery in Elderly Patients with Intertrochanteric Fracture

目的探讨加速康复外科(fast track surgery,FTS)在老年股骨粗隆间骨折病人围手术期中的临床价值。方法采用临床对照研究。连续随访88例在我院骨科实施内固定手术治疗的老年股骨粗隆间骨折病人,其中2007年5月至2008年4月期间治疗的47例患者采用常规手术方案,作为对照组;2008年5月至2009年4月期间治疗的41例患者采用加速康复外科策略,作为研究组;随访至术后12个月,比较两组患者术后并发症发生率、以及术后髋关节功能康复进程。结果加速康复外科组与常规手术方案治疗组相比,术后2周内院内感染、下肢深静脉栓塞等并发症发生率显著降低,比较差异有统计学意义(P≤0.05);随访、评估术后1年内的髋关节功能H arris评分,加速康复外科组患者康复进程加快。结论加速康复外科治疗方案更有利于老年股骨粗隆间骨折病人的治疗。

Objective To evaluate the clinical value of fast track surgery in elderly patients with intertrochanteric fractures by internal fixation.Methods To compare therapeutic result of fast track program and conventional care in elderly patients with intertrochanteric fractures.We prospectively reviewed the medical records of 88 consecutive patients older than 65 years admitted to our hospital,following a intertrochanteric fracture.47 patients were received conventional perioperative care from May 2007 to April 2008,meanwhile other 41 patients were received perioperative fast track rehabilitation from May 2008 to April 2009.Outcomes were assessed by post-operative complication rate and the Harris score.Results Compared with conventional care group,fast track surgery group was associated with a significantly lower post-operative complication rate,and the faster recovery process.Conclusion Fast track surgery is more favourable in guiding the therapy of elderly patients with intertrochanteric fractures.