创伤骨科与内科共管模式在老年髋部骨折患者围手术期的应用价值

doi:10.3760/cma.j.cn441417-20250528-19028

摘要/Abstract

摘要：

目的　探讨创伤骨科与内科共管模式在老年髋部骨折患者围手术期管理中的应用价值。方法　选取2023年1月至2023年12月期间漯河医学高等专科学校第二附属医院收治的60例老年髋部骨折手术患者，采用随机数字表法分为研究组与对照组，各30例。研究组：男14例、女16例，年龄（73.39±5.16）岁，体重指数（BMI）为（25.18±6.16）kg/m²；骨折类型：股骨颈骨折12例、股骨转子间骨折14例、股骨转子下骨折4例；采用创伤骨科与内科共管模式。对照组：男12例、女18例，年龄（73.16±5.87）岁，BMI为（26.12±5.44）kg/m²；骨折类型：股骨颈骨折15例、股骨转子间骨折10例、股骨转子下骨折5例；采用骨科常规诊疗流程。比较两组患者的术后首次下床活动时间、住院天数、住院费用、入院至手术时间、下肢深静脉血栓形成健康信念、患侧肢体肿胀程度、生活质量（SF-36评分），以及术后并发症发生率。统计学方法采用t检验、χ²检验。结果　研究组术后首次下床活动时间、住院天数均短于对照组［（39.16±7.15）h比（59.77±6.87）h、（10.02±1.66）d比（12.11±1.31）d］，差异均有统计学意义（t=11.385、5.413，均P<0.05）；两组住院费用、入院至手术时间差异均无统计学意义（均P>0.05）。出院时，研究组健康信念多维度量表、SF-36评分均高于对照组，术后1 d、3 d、7 d患侧肢体肿胀程度均低于对照组（均P<0.05）；研究组术后并发症发生率低于对照组［16.67%（5/30）比40.00%（12/30）］，差异有统计学意义（χ²=4.022，P<0.05）。结论　创伤骨科与内科共管模式可有效优化老年髋部骨折患者的围手术期管理，缩短恢复时间，提高健康信念和生活质量，降低术后并发症发生率，具有较高的临床应用价值。

关键词:

髋部骨折, 创伤骨科, 内科共管模式, 围手术期, 老年

Abstract:

Objective　To explore the application value of the co-management model of orthopedics and internal medicine in the perioperative management of elderly patients with hip fractures. Methods　Sixty elderly patients with hip fractures who underwent surgery at the Second Affiliated Hospital of Luohe Medical College from January 2023 to December 2023 were selected.The subjects were randomly divided into the study group and the control group by the random number table method, with 30 cases in each group.Research group: 14 males and 16 females, with an average age of (73.39±5.16) years and a body mass index (BMI) of (25.18±6.16) kg/m².Fracture types: 12 cases of femoral neck fractures, 14 cases of intertrochanteric fractures of the femur, and 4 cases of subtrochanteric fractures of the femur.Adopt a co-management model of trauma orthopedics and internal medicine.Control group: 12 male and 18 females, with an average age of (73.16±5.87) years and a BMI of (26.12±5.44) kg/m².The fracture types included 15 cases of femoral neck fractures, 10 cases of intertrochanteric femoral fractures, and 5 cases of subtrochanteric femoral fractures. Adopt the routine diagnosis and treatment procedures of orthopedics. The time of first getting out of bed after surgery, length of hospital stay, hospitalization cost, time from admission to surgery, health belief in deep vein thrombosis of the lower extremities, degree of swelling of the affected limb, quality of life (SF-36 score) and incidence of postoperative complications were compared between the two groups of patients.Statistical methods included t-test and χ² test. Results　The time to get out of bed for the first postoperative activity and the length of hospital stay in the study group were both shorter than those in the control group [(39.16±7.15)h vs. (59.77±6.87)h, (10.02±1.66)d, vs. (12.11±1.31)d], and the differences were statistically significant (t=11.385 and 5.413; both P<0.05).There was no statistically significant difference in hospitalization expenses and the time from admission to operation between the two groups (all P>0.05).At discharge, the health belief score and SF-36 score of deep vein thrombosis of the lower extremities in the study group were higher than those in the control group, and the degree of swelling of the affected limb at 1 day, 3 days and 7 days after the operation was lower than that in the control group (all P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group [16.67% (5/30) vs. 40.00% (12/30)], and the difference was statistically significant (χ²=4.022, P<0.05). Conclusion　The co-management model of trauma orthopedics and internal medicine can effectively optimize the perioperative management of elderly patients with hip fractures, shorten the recovery time, improve health beliefs and quality of life, and reduce the incidence of postoperative complications. It has high clinical application value.

Key words:

Hip fracture, Trauma orthopedics, Internal medicine co-management model, Perioperative period, , Elderly

吴大龙张世魁岳龙李智浩张绍安.

创伤骨科与内科共管模式在老年髋部骨折患者围手术期的应用价值 [J]. 国际医药卫生导报, 2025, 31(19): 3309-3314.

Wu Dalong, Zhang Shikui, Yue Long, Li Zhihao, Zhang Shao'an.

The application value of the joint management model of trauma orthopedics and internal medicine in the perioperative period of elderly patients with hip fractures [J]. International Medicine and Health Guidance News, 2025, 31(19): 3309-3314.

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