摘要
目的探讨建立老年髋部骨折手术治疗绿色通道的短期有效性。方法回顾性分析北京市房山区第一医院2015年1月至2017年9月收治的128例老年髋部骨折患者资料。男44例，女84例；年龄65～9l岁，平均75．5岁。根据受伤至手术时间不同分为绿色通道组（G组）和非绿色通道组（NG组）：63例患者受伤至手术时间为24。48h，作为G组；65例患者受伤至手术时间〉48h，作为NG组。比较两组患者住院期间并发症发生率、术后3个月病死率及髋关节功能优良率。结果两组患者的年龄、性别、入院时内科合并症、骨折类型等数据比较差异均无统计学意义（P〉0．05），具有可比性。所有患者术后获0．5-3．0个月（平均2．7个月）随访。G组术后住院期间总体并发症发生率、坠积性肺炎、急性心肌梗死、急性脑梗死、静脉血栓栓塞症发生率均低于NG组，差异有统计学意义（P〈0．05）。两组患者在谵妄、猝死、压疮、术后泌尿系感染、术后3个月病死率方面差异均无统计学意义（P〉0．05）。两组患者均未出现伤口感染或肺栓塞并发症。G组和NG组分别有47、51例患者术后3个月采用李子荣根据国外髋关节功能评分表修订版评定髋关节功能，优良率分别为76．6％（36／47）、68．6％（35／51），差异无统计学意义（P〉0．05）。结论建立老年髋部骨折手术治疗绿色通道、多学科协作．可显著降低患者术后并发病发牛率．对患者中远期病死率的影响有待于讲一步研奔。
Objective To explore the short-term efficacy of green channel surgery for hip fractures in the elderly patients. Methods A retrospective study was conducted of the 128 elderly patients with hip fracture who had been operatively treated at Department of Orthopaedies, The First People＇s Hospital of Beijing Fangshan from January 2015 to September 2017. They were 44 men and 84 women, aged from 65 to 91 years （average, 75.5 years）. The interval from injury to surgery ranged from 24 to 48 hours for the green channel group of 63 cases but exceeded 48 hours for the non-green channel group of 65 cases. The 2 groups were compared in terms of complications during hospitalization, mortality 3 months after operation and good to ex- cellent rate of hip function. Results The 2 groups were compatible due to insignificant differences in age, gender, internal disease upon admission or fracture type （ P 〉 0. 05 ）. All the patients were followed up for 0. 5 to 3.0 months （average, 2. 7 months） . The total incidence of complications during hospitalization, and incidences of hypostatic pneumonia, acute cardiac and cerebrovascular accidents and venous throm- boembolism were all significantly lower in the green channel group than in the non-green channel group （ P 〈 0.05） . There were no significant differences between the 2 groups in terms of in delirium, sudden death, pressure sore, postoperative urinary infection, or mortality 3 months after operation （ P 〉 0.05）. No wound infection or pulmonary embolism was observed in either group. According to the scoring system for hip func- tions modified by Li Zirong, the good to excellent rate was 76.6% in the green channel group （36/47） and 68.6% （35/51 ） in the non-green channel group, showing no significant difference between the 2 groups （ P 〉 0.05） . Conclusions Establishment of green channel surgery and multidisciplinary collaboration can significantly reduce incidence of postoperative complications. Its effect on the mid- and long-term mortality
作者
王剑
孙新立
朱亚斌
赵志彩
Wang Jian;Sun Xinli;Zhu Yabin;Zhao Zhicai(Department of Orthopaedics,The First People＇s Hospital of Beijing Fangshan,Beijing 102400,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第7期578-582,共5页
Chinese Journal of Orthopaedic Trauma
关键词
老年人
髋骨折
手术后并发症
绿色通道
Aged
Hip fractures
Postoperative complications
Green channel
