快速康复理念在老年髋部骨折治疗应用中的研究进展

Research progress of rapid rehabilitation concept's application in coxa fracture in older adults

快速康复理念是一种通过以循证医学为基础的干预措施来减轻手术应激的全新理念,随着老年髋部骨折的增多以及死亡率的升高,该理念渐渐应用于老年髋部骨折领域。急诊绿色通道的开展,可保障入院24 h内实施手术而降低患者死亡率。术前焦虑的缓解,将有助于减轻术后疼痛,改善术后谵妄。术前、术中、术后多阶段、多模式镇痛方法的运用,有助于围手术期管理和术后康复的进行。术中血液管理的实施,可降低术后感染以及伤口延迟愈合。而术后康复的早期进行,为患者提前恢复肢体功能、减少卧床并发症奠定了坚实的基础。

The concept of rapid rehabilitation is a new strategy to reduce the surgical stress through evidence-based interventions. With the increasing of hip fracture and increased mortality, the concept is gradually applied in the ifeld of hip fractures in the elderly. The development of fast-track can give a guarantee to operation within 24 hours and reduce the mortality of the patients. Relieving anxiety before operation, will be helpful to reduce postoperative pain and postoperative delirium. In preoperative, intraoperative and postoperative stages, multimodal analgesia method is helpful for the perioperative management and postoperative rehabilitation. Implementation of blood management in operation, can reduce the risk of delayed wound healing and postoperative infection. Early postoperative rehabilitation of patients can lay a solid foundation for early recovery of limb function and reduce complications.