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[1]馬江濤,俞敏,俞高峰,等.快速康復外科理論在老年股骨轉子間骨折治療中的應用[J].中醫(yī)正骨,2015,27(01):39-40.
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快速康復外科理論在老年股骨轉子間骨折治療中的應用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年01期
頁碼:
39-40
欄目:
臨床報道
出版日期:
2015-01-15

文章信息/Info

作者:
馬江濤俞敏俞高峰泮立群竺叢慶張孟超
浙江省新昌縣張氏骨傷醫(yī)院,浙江 新昌 312500
關鍵詞:
髖骨折 轉子間骨折 快速康復外科理論 圍手術期醫(yī)護 老年人
摘要:
目的:探討快速康復外科理論在老年股骨轉子間骨折治療中的應用價值。方法:采用快速康復外科理論指導59例老年股骨轉子間骨折患者的治療,男21例,女38例; 年齡65~92歲,中位數(shù)77歲; 左側27例,右側32例。骨折Evans-Jenson分型,Ⅰ型8例、Ⅱ型16例、Ⅲ型25例、Ⅳ型7例、Ⅴ型3例。合并心血管疾病36例、呼吸系統(tǒng)疾病30例、腦血管疾病7例、糖尿病11例。受傷至手術時間3~14 d,中位數(shù)6 d。觀察患者疼痛緩解、髖關節(jié)功能恢復及并發(fā)癥發(fā)生情況。結果:本組59例患者,術后住院時間5~15 d,中位數(shù)7 d; 均獲隨訪,隨訪時間5~20個月,中位數(shù)15個月; 骨折均愈合,愈合時間3~5個月,中位數(shù)3.5個月。術后疼痛緩解、患髖功能改善。參照Harris髖關節(jié)功能評分標準評價患髖功能,末次隨訪時73~90分,中位數(shù)79分。術后并發(fā)消化系統(tǒng)不良反應8例,經藥物對癥處理,癥狀緩解; 并發(fā)急性精神障礙7例,經心理治療及藥物治療,癥狀緩解; 并發(fā)下肢深靜脈血栓形成1例,經溶栓藥物治療,栓塞血管再通; 并發(fā)泌尿、呼吸系統(tǒng)感染各1例,經抗生素等藥物治療,感染控制,癥狀緩解。無切口感染、骨折畸形愈合等并發(fā)癥發(fā)生。結論:采用快速康復外科理論指導老年股骨轉子間骨折的治療,有利于疼痛緩解和患髖功能的改善,并發(fā)癥少,安全可靠。

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備注/Memo

備注/Memo:
2014-07-17收稿 2014-08-14修回
更新日期/Last Update: 2015-01-30