绿色通道建设提高高龄髋部骨折患者治疗的有效性与安全性

发布时间：2018-05-11 06:19

本文选题：老年人 + 髋骨折　；参考：《第二军医大学学报》2017年04期

【摘要】：目的观察绿色通道建设在高龄髋部骨折患者治疗中的应用效果,为高龄髋部骨折患者的规范化治疗提供依据。方法回顾性分析2014年6月—2015年6月经治的115例高龄(≥75岁)髋部骨折患者的临床资料,根据诊治流程不同分为绿色通道组(58例)和常规处理组(57例)。比较两组患者的手术等待时间、手术时间、出血量、住院时间及住院期间的术后全身并发症和局部并发症发生情况。结果绿色通道组手术等待时间(中位数43.6h)明显短于常规处理组(中位数136.8h),差异具有统计学意义(P0.01);绿色通道组住院时间[(4.3±1.2)d]明显短于常规处理组[(8.5±2.5)d],差异具有统计学意义(P0.05);两组手术时间、出血量差异无统计学意义(P0.05)。绿色通道组11例(19.0%)发生并发症,常规处理组29例(50.9%)发生并发症,常规处理组并发症发生率高于绿色通道组(P0.01);绿色通道组肺部感染和压疮的发生率明显低于常规处理组[3.4%(2/58)vs 14.0%(8/57),P0.05;3.4%(2/58)vs 15.8%(9/57),P0.05],两组患者肺栓塞、脑梗死、深静脉血栓、心肌梗死、切口感染发生率差异无统计学意义。结论绿色通道建设应用于高龄髋部骨折的治疗,在条件允许的情况下早期手术有利于缩短高龄髋部骨折患者的住院时间、减少术后并发症,促进髋部功能的康复,对老年髋部骨折的规范化治疗具有重要和积极的意义。
[Abstract]:Objective To observe the effect of green passage construction in the treatment of elderly hip fracture, and to provide basis for standardized treatment of elderly hip fracture patients. Methods the clinical data of 115 elderly patients (75 years old) of hip fracture treated from June 2014 to 2015 were analyzed retrospectively, and the treatment process was divided into green channel group (58) according to the treatment process. Compared with the conventional treatment group (57 cases), the waiting time of operation, the time of operation, the amount of bleeding, the time of hospitalization, the postoperative systemic complications and local complications were compared between the two groups. Results the waiting time (median 43.6h) in the green channel group was significantly shorter than that of the conventional treatment group (median 136.8h), the difference was statistically significant. The hospitalization time of the green channel group [(4.3 + 1.2) d]] was significantly shorter than that of the conventional treatment group [(8.5 + 2.5) d] (8.5 + 2.5) d], and the difference was statistically significant (P0.05); there was no significant difference in the amount of bleeding in the two groups of operation time (P0.05). 11 cases in the green channel group (19%) had complications and 29 cases (50.9%) had complications in the routine treatment group, and the complications in the routine treatment group were complicated. The incidence of pulmonary infection and pressure ulcers in green channel group was significantly lower than that of [3.4% (2/58) vs 14% (8/57), P0.05; 3.4% (2/58) vs 15.8% (9/57), P0.05], two patients with pulmonary embolism, cerebral infarction, deep venous thrombosis, myocardial infarction, and incisional infection rate difference was not statistically significant. Conclusion green passage was found. In the condition permissible, early operation is beneficial to shorten the hospitalization time of the elderly hip fracture patients, reduce the postoperative complications and promote the rehabilitation of the hip function, which is of great significance to the standardized treatment of hip fracture in the elderly.

【作者单位】：第二军医大学长海医院创伤骨科;中韩生物医学工程中心;
【基金】：国家自然科学基金国际合作项目(8141101156) 上海市自然科学基金(15ZR1412500) 上海市科委生物医药专项(15411950600)~~
【分类号】：R687.3

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