高龄老人髋部骨折的治疗风险控制

Management of the Risk of Treating the Elderly Patients with Hip Fracture

目的:探讨高龄老人髋部骨折的治疗风险及控制方法。方法:收集168例手术病例,从伤前日常活动能力、心肺功能等方面进行评估,以并发症的发生与否作为评价围手术期风险的指标,讨论治疗的风险因素及防治措施。结果:本组患者168例,因手术中肺栓塞死亡1例,术后心肌梗死死亡1例,死亡率1.2%,其余均平稳度过围手术期。肺炎8例(4.8%),脑梗或脑出血3例(1.8%),褥疮2例(1.2%)。根据Harris髋关节功能评分标准,优119例,良42例,可5例,总优良率95.8%。结论:高龄老人髋部骨折的治疗风险大,加强围手术期的风险控制是提高手术成功率、减少并发症和降低病死率的重要保证。

Objective： To explore the therapeutic risk and management of the elderly patients with hip fracture.Method： Collected the surgical patients 168, evaluated the ability of daily activities and cardiopulmonary function before the hip fracture.Assessed the perioperative indicators of risk by the complications, to discuss the theralbeutic risk and management of the elderly patients with hip fracture.Result： 168 cases, 1 case died from pulmonary embolism during surgery, 1 case died from myocardial, infarction durittg postopera6.ort, death rate was 1.2%, the others were safe through perioperation. Pneumonia： 8 cases （4.8%）, Cerebral infarction or cerebral hemorrhage： 3 cases （ 1.8% ）, bedsore： 2 cases （ 1.2% ） .According to the evaluation criterion of harris hip function ： excellence ： 119 cases, good： 42 cases, tolerableness ： 5 cases.Rates of excellent-good ： 95.8%.Conclusion： Treatment on the elderly patients with hip fracture has great risk.Controlling the perioperative risk can improve the successful rate of the operation and reduce the complications and mortality.