加速康复外科理念在老年股骨颈骨折股骨头置换术围手术期的应用策略及临床效果

Application Strategy and Clinical Effects of the Enhanced Recovery After Surgery During the Perioperative Period of Fracture of Neck of Femur Among Elderly Patients

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在老年股骨颈骨折围手术期应用策略及临床疗效。方法选取2020年3月至2020年8月期间安徽理工大学第一附属医院40例老年股骨颈骨折接受股骨头置换术治疗的患者资料,其中20例在围手术期应用ERAS模式管理(ERAS组),20例应用常规传统围手术期管理(常规组),对比分析两组患者住院时间、术后短期严重并发症及术前、术后3个月和6个月的VAS评分、Harris评分。结果ERAS组的住院时间短于常规组,差异均有统计学意义(P<0.05),ERAS组术前、术后3个月和6个月的VAS评分低于常规组、Harris评分高于常规组,差异均有统计学意义(P<0.05)。两组术后均无发生感染、褥疮、下肢深静脉血栓等术后短期严重并发症,仅常规组出现1例术后心律不齐。结论ERAS理念应用于老年股骨颈骨折围手术期,可明显缩短患者的住院时间,减轻术前术后疼痛并提升髋关节功能,有利于患者术后康复,值得临床应用。

Objective To investigate the application strategy and clinical effects of the enhanced recovery after surgery(ERAS)during the perioperative period of fracture of neck of femur among elderly patients.Methods 40 selected patients with fracture of neck of femur among elderly patients accepted femoral head replacement from March 2020 to August 2020 in the First Affiliated Hospital of Anhui University of Science and Technology.Twenty cases were treated with ERAS mode during the perioperative period(ERAS group),and twenty cases were treated with conventional perioperative management(conventional group).The hospitalization time,the short-term serious postoperative complications,the VAS scores and the Harris scores before,3 and 6 months after surgery of the patients in the two groups were compared and analyzed.Results The hospitalization time of ERAS group was shorter than that of the conventional group,and the differences were statistically significant(P<0.05).The VAS scores before,3 and 6 months after surgery of ERAS group were lower than that in the conventional group.The Harris scores were higher than that of conventional group,and the differences were statistically significant(P<0.05).No serious postoperative complications such as infection,bedsore and deep venous thrombosis occurred in the two groups,with only one postoperative arrhythmia in the conventional group.Conclusion The application of enhanced recovery after surgery during the perioperative period of fracture of neck of femur among elderly patients can significantly reduce the hospitalization time of patients,relieve preoperative pain and improve hip function,so it is worthy of clinical application.