季斌;刘师良;杨东方;陆雅萍;俞歌;徐明民;谢箐;赵卫卫;施培华;

• 1:浙江大学附属邵逸夫医院
• 2:浙江省嘉兴市第一医院

摘要(Abstract)：

[目的]将快速康复外科(enhanced recovery after surgery, ERAS)理念引入到老年骨质疏松性股骨粗隆间骨折的治疗中,分析探讨ERAS理念在该疾病中的作用及应用前景。[方法] 2016年1月～2018年1月以ERAS理念进行诊治的合并有老年性骨质疏松症的股骨粗隆间骨折患者20例为ERAS组。2015年1月～2017年1月20例以往未引入ERAS理念进行治疗的老年骨质疏松性股骨粗隆间骨折20例为传统组,比较两组的临床效果。[结果]两组患者均顺利手术。ERAS组受伤至手术时间显著少于传统组(P<0.05),ERAS组切口长度、术中失血量、手术时间、住院时间显著优于传统组,差异均有统计学意义(P<0.05)。此外,ERAS组术后VAS评分、HAMA和HAMD均显著优于传统组(P<0.05)。所有患者术后随访12～18个月,ERAS组负重站立时间显著早于传统组,术后6个月ERAS组骨量丢失显著少于传统组,末次随访时ERAS组Harris评分显著高于传统组,差异均有统计学意义(P<0.05)。影像学方面:ERAS组骨折愈合时间显著早于传统组(P<0.05)。至末次随访时,ERAS组髋部无畸形,无内固定物松动、断裂或移位;而传统组20例中,2例内固定失效,包括螺钉切割1例,螺钉松动退出1例;1例内翻畸形。[结论]将ERAS理念引入到老年骨质疏松性粗隆间骨折的治疗中,疗效更佳,恢复更快,满意度更高,安全可靠。

关键词(KeyWords)： 快速康复外科(ERAS);骨质疏松;股骨粗隆间骨折;老年

Abstract:

Keywords:

基金项目(Foundation): 浙江省嘉兴市科技计划项目（编号：2018AD32077）

作者(Author): 季斌;刘师良;杨东方;陆雅萍;俞歌;徐明民;谢箐;赵卫卫;施培华;

Email:

DOI:

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