摘要
目的分析多学科综合治疗(MDT)对老年髋部骨折患者手术预后的影响。方法56例老年髋部骨折患者,按奇偶分类法分为常规组和综合组,每组28例。常规组患者行传统手术治疗方案,综合组患者在常规组基础上行多学科综合评估治疗方案。比较两组患者骨折愈合指标及住院时间;C反应蛋白(CRP)水平;简易精神状态量表(MMSE)评分;术后认知功能障碍(POCD)发生情况;肢体功能恢复状况。结果综合组患者疼痛缓解时间为(2.89±0.37)d,骨折愈合时间为(87.63±2.86)d,下床活动时间为(2.51±0.17)d,住院时间为(11.27±0.57)d,均显著短于常规组的(5.07±0.63)、(99.83±3.16)、(6.01±0.26)、(15.93±0.71)d,,差异均具有统计学意义(P<0.05)。综合组患者手术第2天和第4天CRP分别为(53.56±3.78)、(90.61±3.21)mg/L,均明显低于常规组的(79.67±4.83)、(119.35±3.07)mg/L,差异具有统计学意义(P<0.05)。综合组患者手术第2、4、7天MMSE评分均明显高于常规组,差异具有统计学意义(P<0.05)。综合组患者手术第2、4天POCD发生率分别为7.14%、0,均低于常规组的32.14%、28.57%,差异具有统计学意义(P<0.05)。治疗后3个月,综合组患者的行走功能、稳定性、活动度、疼痛评分均明显高于常规组,差异均具有统计学意义(P<0.05)。结论多学科综合治疗治疗对老年髋部骨折手术预后较好,值得推广。
Objective To analyze the effect of multidisciplinary team(MDT)treatment on the prognosis of hip fracture surgery in the elderly.Methods A total of 56 elderly patients with hip fracture were divided into conventional group and comprehensive group by parity classification,with 28 cases in each group.Conventional group received traditional surgery regimen,and comprehensive group received multidisciplinary team on the basis of conventional group.The fracture healing index,hospitalization time,C-reactive protein(CRP)level,mini-mental state examination(MMSE)score,occurrence of postoperative cognitive dysfunction(POCD)and recovery of limb function were compared between the two groups.Results The pain relief time,fracture healing time,off-bed activity time and hospitalization time of comprehensive group were(2.89±0.37),(87.63±2.86),(2.51±0.17)and(11.27±0.57)d,which were significantly shorter than those of conventional group(5.07±0.63),(99.83±3.16),(6.01±0.26)and(15.93±0.71)d,and the difference was statistically significant(P<0.05).2 and 4 d after surgery,CRP of comprehensive group were(53.56±3.78)and(90.61±3.21)mg/L respectively,which were obviously lower than those of conventional group(79.67±4.83)and(119.35±3.07)mg/L,and the difference was statistically significant(P<0.05).2,4 and 7 d after surgery,MMSE score of comprehensive group were obviously higher than those of conventional group,and the difference was statistically significant(P<0.05).2 and 4 d after surgery,incidence of POCD of comprehensive group were 7.14%and 0 respectively,which were lower than those of conventional group 32.14%and 28.57%,and the difference was statistically significant(P<0.05).3 months after treatment,the walking function,stability,activity,pain score of comprehensive group were obviously higher than those of conventional group,and the difference was statistically significant(P<0.05).Conclusion Multidisciplinary team treatment shows good prognosis for hip fracture surgery in the elderly,and it is worthy of promotion.
作者
梁旭东
巨培祥
LIANG Xu-dong;JU Pei-xiang(Department of Orthopaedics,Yicheng People’s Hospital,Zaozhuang 277300,China)
出处
《中国实用医药》
2020年第19期37-39,共3页
China Practical Medicine
关键词
多学科综合治疗
老年髋部骨折手术
预后
Multidisciplinary team treatment
Hip fracture surgery in the elderly
Prognosis
