ERAS理念在老年单侧新鲜股骨转子间骨折患者治疗中的效果及对其髋关节功能恢复的影响

ERAS Concept in the Treatment of Elderly Patients with Unilateral Fresh Femoral Intertrochanteric Fractures and Its Effect on Hip Joint Function Recovery

目的:探究快速康复外科(enhanced recovery after surgery,ERAS)理念在老年单侧新鲜股骨转子间骨折患者治疗中的临床效果。方法:选取2014年1月-2019年1月于本院就诊的老年单侧新鲜股骨转子间骨折患者60例。按照随机数字表法分为对照组和研究组,各30例。对照组予以常规围术期治疗,研究组予以ERAS理念指导下的围术期治疗。比较两组围术期相关指标、功能状况、并发症发生情况及患者满意度。结果:治疗后,研究组手术时间、住院时间均明显短于对照组,术中出血量、术后引流量均明显少于对照组,差异均有统计学意义(P<0.05)。治疗后,两组VAS、HAMA评分均较治疗前下降,且研究组上述评分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组Harris、FIM评分均较治疗前升高,且研究组上述评分均高于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为10.00%,明显低于对照组的40.00%,差异有统计学意义(P<0.05)。研究组满意度为96.67%,明显高于对照组的70.00%,差异有统计学意义(P<0.05)。结论:ERAS理念应用于老年单侧新鲜股骨转子间骨折患者治疗中,可有效缩短其手术时间,减小手术所造成的创伤,促进其术后恢复,改善患者疼痛情况、焦虑情况、关节功能情况以及日常功能情况,降低并发症发生率,提升患者满意度。

Objective:To explore the clinical effect of enhanced recovery after surgery (ERAS) concept in the treatment of elderly patients with unilateral fresh femoral intertrochanteric fractures.Method:A total of 60 elderly patients with unilateral fresh femoral intertrochanteric fractures who visited our hospital from January 2014 to January 2019 were selected.According to the random number table method,they were divided into control group and study group,30 cases in each group.The control group received conventional perioperative treatment,the study group received perioperative treatment under the guidance of ERAS concept.The perioperative related indexes,functional status,complications and patient satisfaction were compared between the two groups.Result:After treatment,the operation time and hospitalization time of the study group were significantly shorter than those of the control group,the intraoperative blood loss and postoperative drainage volume were significantly less than those of the control group,the differences were statistically significant (P<0.05).After treatment,the VAS and HAMA scores of the two groups decreased compared with those before treatment,and the above scores of the study group were lower than those of the control group,the differences were statistically significant (P<0.05).After treatment,Harris and FIM scores of the two groups were higher than those before treatment,and the above scores of the study group were higher than those of the control group,the differences were statistically significant (P<0.05).The complication rate of the study group was 10.00%,significantly lower than 40.00% of the control group,the difference was statistically significant (P<0.05).The satisfaction of the study group was 96.67%,which was significantly higher than 70.00% of the control group,the difference was statistically significant (P<0.05).Conclusion:ERAS concept applied to elderly patients with unilateral fresh femoral fractures between rotor treatment,which can effectively shorten the operation time,reduce the trauma caused by surgery,promote their recovery and improve the patients’ pain,anxiety,joint function and daily function,reduce the incidence of complications,improve patient satisfaction.