高龄股骨转子周围骨折病人围手术期并发症的观察与护理

目的 总结高龄股骨转子周围骨折病人的围手术期并发症观察与护理。方法2005年6月至2008年3月进行手术治疗的年龄〉80岁股骨转子周围骨折病人48例，股骨转子间骨折41例，股骨转子下骨折4例。统计病人一般资料，观察术前伴随症及围手术期并发症。结果并存术前伴随症33例（68．75％），术前伴随症发病率最高为贫血。发生围手术期并发症17例（35．42％），围手术期并发症发病率最高为肺部感染（16．67％）。性别、年龄、术前时间与发生围手术期并发症无明显相关性（P〉0．05），唯一与围手术期并发症发生存在明显相关性的为术前伴随症，术前伴随症越多，围手术期并发症发生的可能性就越大。结论术前伴随症数量是高龄股骨转子周围骨折病人围手术期并发症的主要影响因素，做好对病人贫血、心血管系统疾病、卧床并发症、术后谵妄、下肢深静脉血栓的观察与护理，在治疗过程中具有重要的作用。

Clinical observation and nursing of perioperative complications in elder patients with peritrochanteric fracture

Objective To summarize perioperative complications in elder patients with peritrochanteric fracture and relative risk factors. Methods 48 cases above 80 years old with peritrochanteric fracture were treated by operation during the period of June 2005 to March 2008. Among them, 41 cases suffered with intertrochanteric fracture and 4 cases suffered with subtroehanteric fracture. There were 16 males and 32 females aged from 80 to 97 years with a mean age of 85 years. The general information and perioperative complications of patients were collected for analysis. Results Among these patients, 33 cases had comorbidities and anaemia is the most common comorbidity. 17 cases developed perioperative complications and the most common postoperative complication was pulmonary infection. The number of preoperative comorbidities was main factor associated with the development of perioperative complications. Conclusion The number of preoperative comorbidities is the significant predictor for development of perioperative complications. Bedridden complications, delirium and deep vein thrombosis are major perioperative complications in elder patients undergoing surgery for peritrochanteric fracture. Close clinical observation and nursing for perioperative complications are important for the recovery of patients.