关键词: 髋部骨折, 股骨粗隆间骨折, 老年患者, 谵妄, 多学科共管

Abstract: Objective　Evaluate the effectiveness of the multidisciplinary co-management model in the perioperative treatment of elderly patients with intertrochanteric femoral fractures. Methods　This study was a randomized controlled trial. 100 patients with intertrochanteric femoral fractures who were admitted to Tengzhou Central People's Hospital from January 2022 to December 2022 were selected as the study subjects. Using simple random sampling method, the patients were divided into the observation group (50 cases) and the control group (50 cases). In the observation group, there were 13 males and 37 females; age (83.76±7.38) years. In the control group, there were 17 males and 33 females; age (84.98±5.91) years. The control group received conventional perioperative management intervention, while the observation group was intervened with a multidisciplinary co-management model. Both groups were intervened until the 5 days after surgery. The incidence of delirium, the delay time of surgery, the length of hospital stay, and the satisfaction during hospitalization were compared between the two groups; the scores of the Visual Analogue Scale (VAS), the Basel Index (BI), and the Richards-Campbell Sleep Questionnaire (RCSQ) were compared between the two groups (at admission, 1 day after surgery, and 5 days after surgery). Independent sample t test, χ² test, Mauchly sphericity test, and repeated measures analysis of variance were used for statistical analysis. Results　The incidence of delirium in the observation group was lower than that in the control group; the delay time of surgery and the length of hospital stay were shorter in the observation group than in the control group; the satisfaction during hospitalization was also higher in the observation group than in the control group [10.00% (5/50) vs. 30.00% (15/50), (1.84±0.37) days vs. (4.12±0.69) days, (12.68±3.50) days vs. (17.06±2.60) days, (95.68±2.55) points vs. (83.92±4.25) points] (all P<0.05). At 1 day and 5 days after surgery, the VAS scores of the observation group were lower than those of the control group, while the BI and RCSQ scores of the observation group were higher than those of the control group (all P<0.05). Conclusion　The multidisciplinary co-management model can effectively reduce the incidence of delirium in elderly patients with intertrochanteric femoral fractures, alleviate pain, improve sleep quality, shorten the delay time of surgery and length of hospital stay, and enhance postoperative functional recovery and satisfaction during hospitalization.

Key words: Hip fracture, Intertrochanteric femoral fracture, Elderly patients, Delirium, Multidisciplinary co-management