多学科协作诊疗在老年髋部骨折治疗中的临床应用

目的探讨多学科协作诊疗模式在老年髋部骨折中治疗应用的临床疗效。方法回顾分析2020年4月至2021年4月北京市房山区良乡医院骨科采用多学科协作诊疗模式治疗的159例老年髋部骨折患者(研究组),与2018年12月至2019年12月采用传统模式治疗的183例患者(对照组)进行比较。结果两组在性别、麻醉ASA分级、髋部骨折类型比较差异无统计学意义(P>0.05)。研究组年龄显著高于对照组(81.4±4.2)岁比(79.6±3.2)岁。研究组手术治疗比例显著高于对照组(89.9%比80.9%)。研究组术前等待时间(3.6±0.4)d、住院时间(10.8±0.3)d,显著短于对照组。研究组院内并发症发生率显著低于对照组(4.40%比6.01%)。研究组120 d病死率显著低于对照组(3.77%比4.37%)。研究组120天Parker功能评分显著优于对照组。结论与传统的诊疗模式相比,多学科协作诊疗模式可以提高老年髋部骨折患者手术比例,缩短术前等待时间和住院时间,降低并发症发生率和病死率,提高功能效果。

Application of multidisciplinary team in the treatment of geriatric hip fractures

Objective To explore the clinical outcome of multidisciplinary team in the treatment of geriatric hip fractures.Methods A retrospective study was performed on 159 elderly patients with hip fracture treated by multidisciplinary team in Department of Orthopedics,Beijing Fangshan liangxiang Hospital from April 2020 to April 2021(study group);and 183 patients treated with traditional approach there from December 2018 to December 2019(control group).Results There was no significant differences in gender,ASA grade and hip fracture type between the two groups(P>0.05).The age of the study group was significantly higher than that of the control group[(81.4±4.2)years vs(79.6±3.2)years].The proportion of surgical treatment in the study group was significantly higher than that in the control group(89.9%vs 80.9%).The preoperative waiting time[(3.6±0.4)d]and hospital stay[(10.8±0.3)d]in the study group was significantly shorter than those in the control group.The incidence of in-hospital complications in the study group was significantly lower than that in the control group(4.40%vs 6.01%).The 120-day mortality of the study group was significantly lower than that of the control group(3.77%vs 4.37%).Parker functional score at 120-day follow up was significantly better in the study group compared with the control group.Conclusion Compared with traditional approach,multidisciplinary team in geriatric hip fractures can increase the proportion of surgical treatment,shorten the preoperative waiting time and hospital stay,reduce the incidence of in-hospital complications and mortality,improve the functional outcome.