| 半髋置换治疗高龄股骨颈骨折的快速康复疗效 |
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投稿时间：2018-07-03
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| 作者 | Author | 单位 | Address | E-Mail |
| 曾智敏 |
ZENG Zhi-min |
宁波市第六医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 351000, Zhejiang, China |
Zhimin001@sina.com |
| 黄哲宇 |
HUANG Zhe-yu |
宁波市第六医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 351000, Zhejiang, China |
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| 陶崑 |
TAO Kun |
宁波市第六医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 351000, Zhejiang, China |
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| 凌晶 |
LING Jing |
宁波市第六医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 351000, Zhejiang, China |
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| 狄正林 |
DI Zheng-lin |
宁波市第六医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 351000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2018年，第31卷，第12期，第1100-1103页 |
| DOI：10.3969/j.issn.1003-0034.2018.12.005 |
| 基金项目: |
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中文摘要:
目的：高龄股骨颈骨折患者应用快速康复理念进行半髋关节置换手术治疗，分析并评价其早期临床疗效。
方法：2015年1月至2016年12月收治股骨颈骨折患者466例，进行回顾性分析，其中高龄患者154例，年龄80~96（83.9±3.2）岁，女127例，男27例，GardenⅢ型68例，GardenⅣ型86例，应用快速康复理念优化围手术治疗策略，进行半髋关节置换手术治疗。记录手术等待时间、手术时间、术后输血率、住院时间、并发症及术后髋关节功能等，统计并分析评价其临床疗效。
结果：154例患者中，12例失访，随访率为92.2%，平均随访时间24.6个月（14~38个月），32例（20.8%）在入院48 h内完成手术，67例（43.5%）在入院72 h内完成手术，76例（49.4%）术后48 h内出院，术后输血率15.9%。1例因假体脱位再次入院，再入院率为0.6%，其余患者无因浅表或深部感染、假体周围骨折再次入院。末次随访患者Harris髋关节评分90.2±7.1，优106例，良23例，可9例。
结论：应用快速康复理念半髋关节置换治疗高龄股骨颈骨折患者，可有效缩短住院时间，减轻患者痛苦，降低输血率，降低术后并发症率，同时不增加患者的再入院率，能取得良好的临床疗效。 |
| 【关键词】股骨颈骨折 康复 关节成形术,置换,髋 |
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| Clinical outcome of enhanced recovery after surgery for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients |
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ABSTRACT
Objective: To analyze and evaluate the clinical outcomes of enhanced recovery after surgery(ERAS) for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients.
Methods: From January 2015 to December 2016,466 patients with femoral neck fractures were admitted in our department. Among them,154 patients were more than 80 years old,with an average age of (83.9±3.2) years old (ranged,80 to 96 years old),including 27 males and 127 females. According to Garden classification system,68 cases were type Ⅲ and others were type Ⅳ. ERAS for hemiarthroplasty were performed for all the patients. The time before operation,blood transfusion rate,complications rate,lenth of stay and Harris score system were evaluated.
Results: Among 154 patients,142 patients were followed up,with an average duration of 24.6 months(ranged,14 to 38 months). Thirty-two patients (20.8%) completed the operation within 48 hours after admission,67 patients(43.5%) completed the operation within 72 hours after admission,76 patients(49.4%) discharged within 48 hours after operation,and the blood transfusion rate was 15.9%. One patient was re-hospitalized because of prosthetic dislocation. The re-hospitalization rate was 0.6%. No other patients were re-hospitalized because of superficial or deep infection or periprosthetic fracture. At the latest follow-up,the Harris hip score was 90.2±7.1,106 patients got an excellent result,23 good and 9 fair.
Conclusion: ERAS for hemiarthroplasty can effectively shorten hospitalization time,relieve pain,reduce blood transfusion rate,reduce postoperative complications,and do not increase the readmission rate of elderly patients with femoral neck fracture,which can achieve good clinical efficacy. |
| KEY WORDS Femoral neck fracture Rehabilitation Arthroplasty,replacement,hip |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 曾智敏,黄哲宇,陶崑,凌晶,狄正林.半髋置换治疗高龄股骨颈骨折的快速康复疗效[J].中国骨伤,2018,31(12):1100~1103 |
| 英文格式: | ZENG Zhi-min,HUANG Zhe-yu,TAO Kun,LING Jing,DI Zheng-lin.Clinical outcome of enhanced recovery after surgery for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(12):1100~1103 |
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