快速康复理念对老年骨质疏松性压缩骨折的影响

目的探讨快速康复理念(fast-track surgery,FTS)在老年骨质疏松性压缩骨折中应用效果。方法 2015年2月—2017年2月将68例平均年龄71.4岁老年骨质疏松性压缩骨折行PKP球囊扩张椎体成形术治疗患者,根据治疗过程中是否应用FTS理念指导行围手术期临床处理,随机分为实验组和对照组,每组34例。实验组在快速康复理念指导下行围手术期临床处理(术前禁食时间、麻醉方式选择、围手术期内环境稳态平衡等),对照组在传统理念下行围手术期处理,观察两组术后住院天数、并发症发生情况、临床疗效。结果实验组术后住院时间(8±3)d明显少于对照组(11±3)d。实验组满意31例,较满意3例;对照组满意25例,较满意9例;实验组治疗优良率(93.1%),治疗优良率明显高于对照组(75.2%,P0.05),术后NRS(数字疼痛评分)评分降低,差异有统计学意义(P0.05)。结论快速康复理念应用于老年骨质疏松性压缩骨折的治疗,安全、可行,与传统理念围手术处理相比,可有效缩短住院时间,减轻患者痛苦,缩短康复周期,节约治疗费用(与传统治疗费用相比节约30%左右)等优点,值得临床推广。

Effect of fast-track surgery on elderly osteoporotic compression fracture

Objective To investigate the effect of fast -track surgery(FTS)on elderly osteoporotic com-pression fractures.Methods A total of 68 elderly osteoporotic fracture patients(average age,71.4 years)were treated with PKP balloon angioplasty.According to whether FTS concept was applied in the course of perioperative clinical treatment,they were divided into experimental group and control group(34 cases in each group).The ex-perimental group received clinical treatment(preoperative fasting time,selection of anesthesia,perioperative homeo-stasis balance,etc.)under the guidance of the concept of FTS,while the control group were treated under the tradi-tional concept of perioperative management.The two groups were observed in aspects of hospitalization days,the in-cidence of complications and clinical efficacy.Results The postoperative hospital stay(8 ±3)d in the experi-mental group was significantly less than that in the control group(11 ±3)d.The experimental group had satisfactory results in 31 cases,less satisfactory results in 3 cases;control group had satisfactory results in 25 cases,less satisfac-tory results in 9 cases;the excellent and good rate of experimental group was 93.1%,and the excellent and good rate was significantly higher than that in the control group(75.2%,P>0.05).After operation,NRS(digital pain score) scores decreased,and the difference was statistically significant(P<0.05).Conclusion The concept of FTS applied to the treatment of osteoporotic fractures in the elderly is safe and feasible.Compared with the traditional concept of perioperative management,it can shorten hospitalization time,alleviate the suffering of patients,shorten the recovery period and save the treatment cost(by 30%approximately).Thus,it is worth of clinical promotion.