加速康复方案在老年转子间骨折治疗中的应用疗效分析

目的：评估老年转子间骨折治疗中应用加速康复方案的临床价值。方法：2016年1月至2018年10月收治80例老年转子间骨折，按处置方案不同分为加速康复组和传统康复组，每组40例，加速康复组男22例，女18例，年龄（78.5±9.1）岁；传统康复组男19例，女21例，年龄（80.6±8.1）岁。比较两组围手术期失血量、并发症发生、入院到手术时间、住院时间、髋关节Harris评分及改良BADL量表评分。结果：80例患者获得12个月以上的随访，平均随访时间（15.4±2.6）个月。加速康复组围手术期总失血量明显低于传统康复组（P<0.001）。两组并发症发生率比较差异无统计学意义（P>0.05）。加速康复组入院至手术时间（1.48±0.51） d，明显低于传统康复组（4.35±1.55） d（t=11.185，P<0.01）；加速康复组住院时间（6.4±1.1） d，明显低于传统康复组（9.9±1.9） d（t=9.958，P<0.01）。术后12个月时，两组髋关节Harris评分比较差异无统计学意义（P>0.05），改良BADL评分比较差异无统计学意义（P>0.05）。结论：加速康复方案在老年转子间骨折中的应用是安全有效的，可以减少围手术期出血量，缩短住院时间，加快髋关节功能的恢复。

Application of accelerated rehabilitation program for the treatment of intertrochanteric fracture of femur in the elderly

Objective:To evaluate the clinical value of accelerated rehabilitation in the treatment of intertrochanteric fracture of femur in the elderly.Methods:Eighty elderly patients with intertrochanteric fractures were selected from January 2016 to October 2018,and were divided into accelerated rehabilitation group and traditional rehabilitation group according to different treatment schemes,40 cases in each group. There were 22 males and 18 females in accelerated rehabilitation group with an average age of (78.5±9.1) years old; 19 males and 21 females in traditional rehabilitation group with an average age of (80.6±8.1) years old. The perioperative blood loss,incidence of complications,hospitalization time,hospital stay,Harris hip score and improved BADL scale were compared between the two groups.Results:Eighty patients were followed up for more than 12 months,with an average follow-up time of (15.4±2.6) months. The total perioperative blood loss in the accelerated rehabilitation group was significantly lower than that in the traditional rehabilitation group(P<0.001). Although the incidence of complications in the accelerated rehabilitation group was lower than that in the traditional rehabilitation group,there was no significant difference between the two groups(P>0.05). The time from admission to operation of the accelerated rehabilitation group(1.48±0.51) days was significantly shorter than that of the traditional rehabilitation group(4.35±1.55) days(P<0.01);the hospitalization time of the accelerated rehabilitation group was(6.4±1.1) days was significantly shorter than that of the traditional rehabilitation group (9.9±1.9) days(P<0.01). At 12 months after operation,there was no significant difference in Harris score between the two groups(P>0.05),and there was no significant difference in modified BADL score between the two groups(P>0.05).Conclusion:The application of accelerated rehabilitation program in elderly intertrochanteric fracture is safe and effective. It can reduce perioperative bleeding,shorten hospitalization time and accelerate the recovery of hip function.