改良手术评估表在老年髋部骨折中的应用

Application of Modified Operation Evaluation Table in Elderly hip Fracture

目的：探讨改良手术评估表在老年髋部骨折中价值和效果。方法：手术治疗90例老年髋部骨折患者，术前进行手术风险评估，按入院时间分成2组，对照组患者48例，采用传统NNIS进行手术风险评分；观察组患者42例，采用改良手术评估表进行手术风险评估。比较2组患者术后并发症（卧床并发症、感染、深静脉血栓）的发生率及死亡率。结果：治疗后住院期间出现并发症36例，对照组24例，观察组12例。对照组NMS评分对治疗后并发症发生率及病死率的预测结果显示预测值均明显高于实际值（P〈0．05）。观察组改良评估表对治疗后并发症发生率及病死率的预测结果显示，预测值与实际值相比较差异均无统计学意义（P〉0．05）。结论：采取改良手术评估表，术前增加体重指数、营养状况、不良习惯及心理评估等指标；术后增加隐性失血量、并发症及心理评估等指标，对老年髋部骨折患者的围手术期风险预测更精确，有利于医护人员对老年患者制定更个性化的治疗方案，改善患者的生活质量。

Objectiv： To explore the value and effect of modified surgical evaluation table in elderly hip fracture. Methods： Surgical treatment of 90 elderly patients with hip fracture, preoperative risk assessment. The patients were divided into two groups according to the time of admission： 48 patients in the control group were treated with traditional NNIS, and 42 patients in the experimental group were eval- uated with modified operation evaluation table. The incidence of postoperative complications and mortality were compared between the two groups. Results： There were 36 cases of complications after treatment, 24 cases in the control group, and 12 cases in the experimental group. The predictive value of the NNIS score in the control group after treatment was significantly higher than the actual value （P 〈 0. 05）. The modified evaluation scale of the experimental group showed no significant difference between the predicted value and the actual value after treatment （P 〉 0.05 ）. Conclusion： The modified surgery assessment scale for elderly patients with hip fracture perioperative risk prediction more accurate, facilitate medical treatment plan more personalized for elderly patients, improve the quality of life of pa- tients.