[1]王正安,游镇君,蒋毅.快速康复外科理念在老年股骨转子间骨折围手术期治疗中的 应用[J].中医正骨,2019,31(11):17-20.
　WANG Zheng'an,YOU Zhenjun,JIANG Yi.Application of rapid rehabilitation theory in perioperative treatment of intertrochanteric fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(11):17-20.
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快速康复外科理念在老年股骨转子间骨折围手术期治疗中的 应用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年11期
页码:
17-20
栏目:
临床研究
出版日期:
2019-11-20

文章信息/Info

Title:
Application of rapid rehabilitation theory in perioperative treatment of intertrochanteric fractures in the aged
作者:
王正安; 游镇君; 蒋毅
(嘉兴市第一医院,浙江 嘉兴 314000)
Author(s):
WANG Zheng'an; YOU Zhenjun; JIANG Yi
The First Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China
关键词:
髋骨折;  转子间骨折;  骨折固定术; 髓内;  围手术期;  康复;  老年人
Keywords:
hip fractures;  intertrochanteric fractures;  fracture fixation; intramedullary;  perioperative period;  rehabilitation;  aged
摘要:
目的:探讨快速康复外科理念在老年股骨转子间骨折围手术期治疗中的应用价值。方法:回顾性分析2016年1月至2018年4月接受髓内钉内固定术治疗的80例老年股骨转子间骨折患者的病例资料,围手术期采用快速康复外科理念治疗者(快速康复组)和传统康复方法治疗者(传统康复组)各40例。比较2组患者的手术时间、术中出血量、术后首次下地时间、住院时间、骨折愈合时间、末次随访时Harris髋关节功能评分及并发症发生情况。结果:所有患者均获随访,随访时间12～24个月,中位数19个月。快速康复组与传统康复组相比,前者的手术时间短[(66.25±8.17)min,(86.95±6.09)min,t=12.850,P=0.000]、术中出血量少[(85.50±13.77)mL,(132.5±17.50)mL,t=13.350,P=0.000]、术后首次下地时间早[(8.10±1.50)d,(16.05±3.24)d,t=14.080,P=0.000]、住院时间短[(8.50±1.65)d,(16.15±1.96)d,t=18.920,P=0.000]、骨折愈合时间短[(9.6±1.08)周,(16.05±1.71)周,t=20.170,P=0.000]、末次随访时Harris髋关节功能评分高[(93.05±1.91)分,(80.05±5.95)分,t=13.150,P=0.000]。快速康复组1例出现下肢深静脉血栓,传统康复组3例出现下肢深静脉血栓,均通过常规抗凝治疗治愈。所有患者均未出现切口感染、神经或血管损伤、骨折不愈合、内固定失败及股骨头坏死。结论:采用快速康复外科理念对老年股骨转子间骨折患者进行围手术期治疗,综合疗效优于传统康复治疗,且并发症少,值得临床推广应用。
Abstract:
Objective:To explore the applied values of rapid rehabilitation theory in perioperative treatment of intertrochanteric fractures in the aged.Methods:The medical records of 80 aged patients with intertrochanteric fractures who received intramedullary nail internal fixation from January 2016 to April 2018 were analyzed retrospectively.Forty patients were treated under the guidance of rapid rehabilitation theory in perioperative period(rapid rehabilitation group),while the others were treated with conventional rehabilitation therapy in perioperative period(conventional rehabilitation group).The operative time,intraoperative blood loss,postoperative bed rest time,hospital stays,fracture healing time,Harris hip function scores at last follow-up and postoperative complication incidences were recorded and compared between the 2 groups.Results:All patients in the 2 groups were followed up for 12-24 months with a median of 19 months.The operative time,postoperative bed rest time,hospital stays and fracture healing time were shorter and the intraoperative blood loss was less and the Harris hip function scores at last follow-up were higher in rapid rehabilitation group compared to conventional rehabilitation group(66.25+/-8.17 vs 86.95+/-6.09 minutes,t=12.850,P=0.000; 8.10+/-1.50 vs 16.05+/-3.24 days,t=14.080,P=0.000; 8.50+/-1.65 vs 16.15+/-1.96 days,t=18.920,P=0.000; 9.6+/-1.08 vs 16.05+/-1.71 weeks,t=20.170,P=0.000; 85.50+/-13.77 vs 132.5+/-17.50 mL,t=13.350,P=0.000; 93.05+/-1.91 vs 80.05+/-5.95 points,t=13.150,P=0.000).The lower extremity deep venous thrombosis was found in 1 patient in rapid rehabilitation group and 3 patients in conventional rehabilitation group.The lower extremity deep venous thrombosis was cured after treatment with conventional anticoagulant therapy.No complications such as incision infection,damage of nerve or blood vessel,fracture nonunion,failed internal fixation and femur head necrosis were found in the 2 groups.Conclusion:The therapy under the guidance of rapid rehabilitation theory achieves better clinical curative effect,with less complications as compared with conventional rehabilitation therapy in perioperative treatment of intertrochanteric fracture in the aged,so it is worthy of popularizing in clinic.

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备注/Memo

备注/Memo:
基金项目:嘉兴市科技计划自主设计研发项目(2016BY28008) 通讯作者:蒋毅 E-mail:jiangyi0573@163.com(收稿日期:2019-08-02 本文编辑:郭毅曼)
更新日期/Last Update: 2019-11-10