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[1]王正安,游鎮(zhèn)君,蔣毅.快速康復(fù)外科理念在老年股骨轉(zhuǎn)子間骨折圍手術(shù)期治療中的 應(yīng)用[J].中醫(yī)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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快速康復(fù)外科理念在老年股骨轉(zhuǎn)子間骨折圍手術(shù)期治療中的 應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年11期
頁碼:
17-20
欄目:
臨床研究
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; 游鎮(zhèn)君; 蔣毅
(嘉興市第一醫(yī)院,浙江 嘉興 314000)
Author(s):
WANG Zheng'an; YOU Zhenjun; JIANG Yi
The First Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China
關(guān)鍵詞:
髖骨折;  轉(zhuǎn)子間骨折;  骨折固定術(shù); 髓內(nèi);  圍手術(shù)期;  康復(fù);  老年人
Keywords:
hip fractures;  intertrochanteric fractures;  fracture fixation; intramedullary;  perioperative period;  rehabilitation;  aged
摘要:
目的:探討快速康復(fù)外科理念在老年股骨轉(zhuǎn)子間骨折圍手術(shù)期治療中的應(yīng)用價值。方法:回顧性分析2016年1月至2018年4月接受髓內(nèi)釘內(nèi)固定術(shù)治療的80例老年股骨轉(zhuǎn)子間骨折患者的病例資料,圍手術(shù)期采用快速康復(fù)外科理念治療者(快速康復(fù)組)和傳統(tǒng)康復(fù)方法治療者(傳統(tǒng)康復(fù)組)各40例。比較2組患者的手術(shù)時間、術(shù)中出血量、術(shù)后首次下地時間、住院時間、骨折愈合時間、末次隨訪時Harris髖關(guān)節(jié)功能評分及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲隨訪,隨訪時間12～24個月,中位數(shù)19個月。快速康復(fù)組與傳統(tǒng)康復(fù)組相比,前者的手術(shù)時間短[(66.25±8.17)min,(86.95±6.09)min,t=12.850,P=0.000]、術(shù)中出血量少[(85.50±13.77)mL,(132.5±17.50)mL,t=13.350,P=0.000]、術(shù)后首次下地時間早[(8.10±1.50)d,(16.05±3.24)d,t=14.080,P=0.000]、住院時間短[(8.50±1.65)d,(16.15±1.96)d,t=18.920,P=0.000]、骨折愈合時間短[(9.6±1.08)周,(16.05±1.71)周,t=20.170,P=0.000]、末次隨訪時Harris髖關(guān)節(jié)功能評分高[(93.05±1.91)分,(80.05±5.95)分,t=13.150,P=0.000]。快速康復(fù)組1例出現(xiàn)下肢深靜脈血栓,傳統(tǒng)康復(fù)組3例出現(xiàn)下肢深靜脈血栓,均通過常規(guī)抗凝治療治愈。所有患者均未出現(xiàn)切口感染、神經(jīng)或血管損傷、骨折不愈合、內(nèi)固定失敗及股骨頭壞死。結(jié)論:采用快速康復(fù)外科理念對老年股骨轉(zhuǎn)子間骨折患者進行圍手術(shù)期治療,綜合療效優(yōu)于傳統(tǒng)康復(fù)治療,且并發(fā)癥少,值得臨床推廣應(yīng)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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備注/Memo

備注/Memo:
基金項目:嘉興市科技計劃自主設(shè)計研發(fā)項目(2016BY28008) 通訊作者:蔣毅 E-mail:[email protected](收稿日期:2019-08-02 本文編輯:郭毅曼)
更新日期/Last Update: 2019-11-10