加速康复外科护理对老年股骨颈骨折患者术后恢复及认知功能的影响

Effects of Enhanced Recovery After Surgery Nursing on Postoperative Recovery and Cognitive Function in Elderly Patients with Femoral Neck Fracture

目的观察加速康复外科护理对老年股骨颈骨折患者术后恢复及认知功能的影响。方法选取本院接受股骨颈骨折手术的老年患者60例,随机分为加速康复外科(enhanced recovery after surgery,ERAS)组和对照组,每组30例。ERAS组采用加速康复外科护理措施,对照组采用传统围手术期护理措施,比较两组住院时间、术后疼痛评分、术后并发症发生情况以及术前1天和术后第7天的简明精神状态量表评分。结果与对照组比较,ERAS组术后住院时间缩短,术后疼痛评分降低,切口感染、肺部感染、恶心呕吐等并发症发生率降低,差异均有统计学意义(P<0.05或P<0.01);ERAS组术后髋关节功能Harris得分评级优于对照组(P=0.021);ERAS组POCD发生率低于对照组,差异具有统计学意义(P=0.046)。结论加速康复外科护理可安全应用于老年患者股骨颈骨折术围手术期管理,可以促进术后恢复、缩短住院天数、减少并发症的发生,降低POCD发生率,值得临床推广。

Objective To investigate whether enhanced recovery after surgery(ERAS)nursing can promote the postoperative recovery of elderly patients with femoral neck fracture and reduce the incidence of postoperative cognitive dysfunction(POCD).Methods A total of 60 elderly patients who underwent femoral neck fracture surgery were divided into ERAS group and control group,with 30 cases in each group.The ERAS group received ERAS nursing measures,and the control group received traditional perioperative nursing measures.The length of hospital stay,postoperative pain score,incidence of postoperative complications,and Mini-Mental State Examination scores 1 day before and 7 days after surgery were compared between the two groups.Results Compared with the control group,the ERAS group had a significantly shorter postoperative length of hospital stay and significantly lower postoperative pain score and incidence of complications such as incision infection,pulmonary infection,and nausea and vomiting(P<0.05 or P<0.01).The Harris Hip Score after surgery was significantly better in the ERAS group than in the control group(P=0.021).The ERAS group had a significantly lower incidence of POCD than the control group(P=0.046).Conclusion ERAS nursing can be safely applied to perioperative management of elderly patients with femoral neck fracture,which can promote postoperative recovery,shorten the length of hospital stay,and reduce complications and POCD incidence.It holds promise for clinical application.