80岁及以上髋部骨折患者围手术期治疗的探讨

目的探讨80岁及以上老年人髋部骨折的围手术期治疗特点。方法回顾性分析1996—2003年手术治疗的80～96岁170例老年髋部骨折患者的资料。结果170例中，股骨颈骨折82例，粗隆间骨折88例。术前128例(75．3％)有并存症，其中心脑血管系统疾病最常见(67例)。术后36例(21．2％)发生并发症，其中神经精神系统(12例)和心血管系统(10例)最为高发。本组患者平均住院18．6d，住院期间死亡2例，分别死于脑梗死及吸人性肺炎、呼吸衰竭。140例获随访，平均随访3．6年，功能总优良率81．5％。结论老年人髋部骨折的手术治疗是安全和有效的，积极的围手术期治疗和精心护理是手术治疗成功的重要条件。

Management of hip fracture during perioperative period in elderly patients aged 80 years and over

Objective To investigate the perioperative management of hip fracture in the elderly aged 80 years and over Methods An retrospective data of the elderly aged 80 years and over who received surgical treatment between Jan 1996 and Jun 2003 were reviewed The surgical procedure was determined according to the fracture type, osteoporosis and patients' health status Data of comorbidities, in hospital complications and other important data were collected Follow up lasting more than 6 months was made to evaluate the recovery Results Eighty two cases were femoral neck fracture while 88 cases were intertrochanteric fracture Their ages ranged from 80 to 96 years with an average of 84 9 years One hundred and twenty eight cases (75 3%) had preoperative comorbidities in which the circulation system was most often involved Thirty six cases (21 2%) had postoperative complications , among which the central nervous system and circulation system were most often involved The average in hospital time was 18 6 days , and 2 cases died of cerebral embolism and respiratory dysfunction in perioperative period respectively Totally 81 5% of them showed a good functional recovery in the follow up Conclusions The right operative intervention to the very aged hip fracture patients is feasible and effective Monitering the perioperative medical conditions and careful nursing should be emphasized