Gustafson Y, Brännström B, Berggren D, Ragnarsson J I, Sigaard J, Bucht G, Reiz S, Norberg A, Winblad B
Dept. of Geriatric Medicine, University of Umeå, Sweden.
J Am Geriatr Soc. 1991 Jul;39(7):655-62. doi: 10.1111/j.1532-5415.1991.tb03618.x.
The aim of this study was to evaluate the effect of a geriatric-anesthesiologic intervention program for the prevention and treatment of acute confusional states (ACS) in elderly patients treated for femoral neck fractures. The intervention program was based on the results of previous prospective studies in similar patient populations. The outcome of the intervention, comprising 103 patients, was compared with that of an earlier study comprising 111 patients. The intervention program consisted of pre- and post-operative geriatric assessments, oxygen therapy, early surgery, prevention and treatment of peri-operative blood pressure falls and treatment of post-operative complications. The incidence of ACS was lower, 47.6%, in the intervention study compared with 61.3% (P less than 0.05) in the control study. Furthermore, the ACS that occurred in the intervention study was less severe and of shorter duration than that in the control study. The incidence of post-operative decubital ulcers, severe falls, and urinary retention was also lower. The mean duration of orthopedic ward stay was 17.4 days in the control study and 11.6 days in the intervention study (P less than 0.001). It can be concluded that the intervention program reduced the incidence, severity, and duration of ACS which resulted in a shortened orthopedic ward stay.
本研究的目的是评估一项老年麻醉干预计划对接受股骨颈骨折治疗的老年患者预防和治疗急性意识模糊状态（ACS）的效果。该干预计划基于此前对类似患者群体进行的前瞻性研究结果。将包含103例患者的干预结果与早期一项包含111例患者的研究结果进行比较。干预计划包括术前和术后老年评估、氧疗、早期手术、预防和治疗围手术期血压下降以及治疗术后并发症。干预研究中ACS的发生率较低，为47.6%，而对照研究中的发生率为61.3%（P<0.05）。此外，干预研究中发生的ACS比对照研究中的病情较轻且持续时间较短。术后褥疮、严重跌倒和尿潴留的发生率也较低。对照研究中骨科病房的平均住院时间为17.4天，干预研究中为11.6天（P<0.001）。可以得出结论，该干预计划降低了ACS的发生率、严重程度和持续时间，从而缩短了骨科病房的住院时间。
