老年股骨近端骨折多学科一体化诊疗的经验

Experience in Multidisciplinary Diagnosis and Treatment of Proximal Femoral Fractures in the Elderly

目的评估多学科一体化诊疗模式管理老年股骨近端骨折的效果。方法选取该院2016年1月—2018年1月收治的老年股骨近端骨折95例患者,作为观察组,均实行多学科一体化诊疗,另选取2014年1月—2015年12月期间收治的152例老年股骨近端骨折患者,作为对照组,未实行多学科一体化诊疗,评估两者手术情况、48h内手术比率、褥疮、肺部感染等并发症几率。结果观察组83例手术治疗,手术率87.4%,48 h之内手术54例,占56.8%,与对照组比较差异有统计学意义(χ~2=4.73、5.82,P<0.05);观察组肺部感染11.6%、循环系统并发症12.6%、褥疮发生率10.5%、神志改变发生率17.9%,显著低于对照组,比较差异有统计学意义(χ~2=4.29、3.99、4.18、4.01,P<0.05)。结论使用多学科一体化诊疗模式可有效管理老年股骨近端骨折。

Objective To evaluate the effect of multidisciplinary integrated diagnosis and treatment model on the management of proximal femoral fractures in the elderly. Methods A total of 95 patients with proximal femoral fractures in the hospital from January 2016 to January 2018 were enrolled. All the patients in the observation group were treated with multidisciplinary diagnosis and treatment. The patients were admitted from January 2014 to December 2015. In the 152 elderly patients with proximal femoral fractures, as a control group, multidisciplinary diagnosis and treatment were not performed, and the complications such as the operation rate, the intraoperative rate within 48 hours, hemorrhoids, and pulmonary infection were evaluated. Results In the observation group, 83 cases were treated with surgery. The operation rate was 87.4%. 54 cases were operated within 48 hours, accounting for 56.8%. The difference was statistically significant compared with the control group （χ2=4.73, 5.82, P〈0.05）. The observation group had pulmonary infection 11.6%, circulatory system complications 12.6%, acne incidence rate 10.5%, and conscious change rate 17.9%, significantly lower than the control group, the difference was statistically significant （χ2=4.29, 3.99, 4.18, 4.01, P〈0.05）. Conclusion The multidisciplinary integrated diagnosis and treatment model can effectively manage the proximal femoral fractures in the elderly.