快速康复外科理念和老年综合评估在高龄骨质疏松性椎体压缩性骨折患者椎体成形术围手术期管理的临床应用

Clinical application of enhanced recovery after surgery and comprehensive geriatric assessment in perioperative management of vertebroplasty in elderly patients with osteoporotic vertebral compression fracture

目的探讨快速康复外科(ERAS)理念与老年综合评估(CGA)结合运用于高龄骨质疏松性椎体压缩性骨折(OVCF)患者围手术期的临床效果。方法以2022年6月—2023年6月收治的70例高龄OVCF患者为研究对象,采用CGA对患者进行评价,共62例可采用经皮椎体成形术治疗,其中29例采用ERAS理念治疗及护理(ERAS组),33例采用普通围手术期管理模式(对照组)。收集住院时间、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及治疗满意度。结果ERAS组患者住院时间、手术前后VAS评分、术后ODI低于对照组,患者满意率高于对照组,差异均有统计学意义(P<0.05)。结论在高龄OVCF患者围手术期引入ERAS与CGA综合管理模式,可快速缓解疼痛、提高患者生活自理能力、降低应激反应和并发症发生率,促进康复,提高满意度,值得推广。

Objective To investigate the clinical application and effects of enhanced recovery after surgery(ERAS)combined with comprehensive geriatric assessment(CGA)in the perioperative period of elderly patients with osteoporotic vertebral compression fracture(OVCF).Methods From June 2022 to June 2023,70 elderly OVCF patients were enrolled in the study.After CGA evaluation,62 out of 70 patients underwent percutaneous vertebroplasty.Among the 62 patients,29 received ERAS treatment(ERAS group),and the remaining 33 did general perioperative management mode(control group).The data including hospital stay,visual analogue scale(VAS)score,Oswestry disability index(ODI)and patients’satisfaction were collected and analyzed.Results In the ERAS group,the hospital stay,preoperative and postoperative VAS scores and postoperative ODI were lower than those in the control group,and the patients’satisfaction was higher than that in the control group,all with a statistical significance(P<0.05).Conclusions Introducing the ERAS and CGA integrated management model during the perioperative period of elderly OVCF patients can quickly alleviate pain,improve patients’self-care ability,reduce stress reactions and the incidence of complications,promote rehabilitation,and improve satisfaction,thus being worth to be popularized clinically.