新型冠状病毒肺炎疫情下加速康复外科理念在老年髋部骨折急诊快通道中的应用效果

目的 探讨新型冠状病毒肺炎(COVID-19)疫情下加速康复外科(ERAS)理念在老年髋部骨折急诊快通道中的应用效果.方法 对COVID-19疫情期间东南大学附属南京中大医院创伤骨科于2020年3月至2021年3月与2021年4月至9月分别通过急诊常规救治流程(对照组)和依据ERAS理念实施优化的急诊快通道流程(快通道...

Effects of the application of the fast track in treatment of geriatric hip fracture at emergency under the guidance of theory of enhanced recovery after surgery in COVID-19 epidemic

Objective To investigate the effects of the application of the fast track in geriatric hip fracture at emergency under the guidance of theory of enhance recovery after surgery(ERAS)in COVID-19 epidemic.Methods Clinical data of 197 patients with geriatric hip fracture treated in the Department of Orthopedic Trauma,Zhongda Hospital Southeast University were analyzed retrospectively.Among them,154 patients admitted through routine emergency access between March 2020 and March 2021 were assigned to control group(CG)and 43 patients admitted through the emergency fast track between April and September 2021 were assigned to the fast track group(FTG).The perioperative waiting time,the proportion of patients who completed surgery within 48 h of admission,NRS analoguo scale,analgesic treatment,Hb level,blood gas level,hematology alternations,hospitalization time and postoperative complications of the 2 groups were recorded and compared.Results In FTG,the preoperative waiting time was longer than that of CG,the Hb level was lower than that of CG and the total length of hospital stay was thorter than that of CG(P<0.001,P=0.008,P=0.001).There were no significant difference in the length of postoperative hospital stay and NRS value between the 2 groups(all P>0.05).Compared to the CG,the proportion of patients with further analgesic measures after admission was decreased,the perioperative waiting time was decreased,the proportion of patients who completed surgery within 48 h of admission rised,the hospitalization time was decreased,and the postoperative complication was decreased in FTG,but all the differences were not significant.The arterial blood gas analysis was performed in 100%patients in FTG and 4.55%in CG,and 51.2%hypoxemia of elderly patients with hip fracture was found.Conclusion Optimization of the medical treatment process and establishment of the fast track for elderly patients with hip fractures according to the ERAS concept could reduce hospital stay and promote the rehabilitation of the patients.