Department of Respiratory Medicine, Centro Hospital Conde de Sao Januario, Macau, China.
Osteoporos Int. 2010 Dec;21(Suppl 4):S579-86. doi: 10.1007/s00198-010-1427-7. Epub 2010 Nov 6.
Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.
髋部骨折是老年人常见的损伤。尽管与其他治疗方式相比,接受髋部骨折手术的患者能获得最佳的功能恢复,但术后肺部并发症(如肺不张、肺炎和肺血栓栓塞症)的存在可能会导致住院时间延长、围手术期发病率和死亡率增加。本综述旨在为减少髋部骨折手术后肺部并发症的风险提供术前评估和围手术期策略的循证建议。临床评估和基本实验室结果足以对术后肺部并发症的风险进行分层。有充分记录的肺部并发症风险因素包括高龄、一般健康状况差、当前感染、心肺疾病、低白蛋白血症和肾功能受损。除了优化患者的身体状况外,肺部扩张手法和血栓预防等干预措施已被证明可有效降低髋部骨折手术后肺部并发症的风险。