老年髋部骨折患者围手术期常见问题多学科管理共识

Consensus on Multidisciplinary Management of Common Perioperative Problems in Elderly Patients with Hip Fracture

随着社会老龄化的加剧以及老年人因衰弱等原因导致的跌倒发生率增加,髋部骨折的手术量也随之上升。为了提高老年髋部骨折患者手术的安全性,降低致死率和致残率,并改善其生活质量,围手术期的多学科综合管理得到了广泛的认可。这种管理方式涉及多个专业领域,如内科、外科、康复科、营养科等,旨在为患者提供全面的治疗和护理,确保手术前后患者的身体和心理状态得到最佳的维护和恢复。通过这种综合管理,可以有效减少手术风险,加快康复进程,并最终提高老年患者的生活质量。为此,天津医科大学总医院骨科团队牵头组建多学科专家团队,查询国内外围手术期管理和创伤骨科加速康复的相关研究证据,围绕老年髋部骨折手术患者围手术期突出的重点问题,如疼痛、营养缺乏、贫血、糖尿病、高血压、肾病等制定围手术期常见问题多学科管理共识,旨在更好地规范和指导创伤骨科临床诊治、护理及康复等工作,降低手术风险,规避并发症在围手术期的发生,提高患者生存率,促进术后功能恢复,从而提升患者生存质量。

With the intensification of social aging and the increasing incidence of falls among the elderly due to frailty and other reasons,the surgical volume for hip fractures has also risen.In order to enhance the safety of surgical procedures for elderly patients with hip fractures,reduce mortality and disability rates,and improve their quality of life,multidisciplinary perioperative management has gained widespread recognition.This management approach involves multiple professional fields such as internal medicine,surgery,rehabilitation,nutrition,and others,aiming to provide patients with comprehensive treatment and care to ensure that their physical and psychological states are optimally maintained and restored before and after surgery.Through this multidisciplinary management,surgical risks can be effectively reduced,the recovery process accelerated,and ultimately,the quality of life for elderly patients improved.To this end,the orthopedic team at Tianjin Medical University General Hospital has taken the lead in establishing a multidisciplinary expert team.They have conducted research on perioperative management and accelerated recovery in traumatic orthopedics both domestically and internationally,focusing on prominent and key issues during the perioperative period for elderly patients undergoing hip fracture surgery,such as pain,malnutrition,anemia,diabetes,hypertension,kidney disease,and others.They have formulated a multidisciplinary management guide for common perioperative issues,aiming to better standardize and guide clinical diagnosis,treatment,nursing,and rehabilitation in traumatic orthopedics.This is done to reduce surgical risks,avoid the occurrence of complications during the perioperative period,increase patient survival rates,promote postoperative functional recovery,and ultimately enhance patients'quality of life.