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术后加速康复可加快髋部骨折患者的愈合。

Enhanced recovery after surgery speeds up healing for hip fracture patients.

作者信息

Long Xia, Li Wen, Hou Dan, Li Xiaoyue, Cheng Dongyue

机构信息

Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University Luzhou 646000, Sichuan, China.

出版信息

Am J Transl Res. 2024 Jul 15;16(7):3231-3239. doi: 10.62347/AEVL7890. eCollection 2024.

DOI:10.62347/AEVL7890
PMID:39114676
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11301509/
Abstract

OBJECTIVE

To investigate the effects of enhanced recovery after surgery (ERAS) on the perioperative healing and stress response in patients with hip fractures.

METHODS

A retrospective analysis was conducted on the medical records of 86 patients with hip fractures admitted to the Affiliated Hospital of Southwest Medical University between January 2022 and August 2023. Among them, 48 patients in the research group received ERAS, while 38 patients in the control group received conventional nursing. Hip joint function, pain levels, stress response, fracture healing time, incidence of complications, and nursing satisfaction were compared between the two groups.

RESULTS

After nursing, the Harris scores notably increased in both groups, with the research group showing notably higher scores compared to the control group (P<0.05). The levels of cortisol and epinephrine, as well as the visual analog scale scores significantly decreased in both groups, with the research group showing significantly lower levels (P<0.05). In addition, the research group experienced significantly shorter fracture healing time (P<0.05), higher nursing satisfaction (P=0.014), and lower incidence of complications (P=0.028). Logistic regression analysis revealed that age, underlying diseases, nursing method, emotional disorders, and timing of surgery were independent factors influencing the post-nursing outcomes.

CONCLUSION

The ERAS mode can effectively alleviate pain, improve hip joint function, reduce fracture healing time and complications, mitigate stress response, and accelerate postoperative recovery in patients with hip fractures. It is worthy of application and promotion in clinical practice.

摘要

目的

探讨术后加速康复(ERAS)对髋部骨折患者围手术期愈合及应激反应的影响。

方法

回顾性分析2022年1月至2023年8月西南医科大学附属医院收治的86例髋部骨折患者的病历资料。其中,研究组48例患者接受ERAS,对照组38例患者接受常规护理。比较两组患者的髋关节功能、疼痛程度、应激反应、骨折愈合时间、并发症发生率及护理满意度。

结果

护理后,两组患者的Harris评分均显著提高,研究组评分显著高于对照组(P<0.05)。两组患者的皮质醇和肾上腺素水平以及视觉模拟量表评分均显著降低,研究组水平显著更低(P<0.05)。此外,研究组骨折愈合时间显著缩短(P<0.05),护理满意度更高(P=0.014),并发症发生率更低(P=0.028)。Logistic回归分析显示,年龄、基础疾病、护理方法、情绪障碍及手术时机是影响护理后结局的独立因素。

结论

ERAS模式可有效减轻髋部骨折患者的疼痛,改善髋关节功能,缩短骨折愈合时间并减少并发症,减轻应激反应,加速术后康复。值得在临床实践中应用推广。

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Osteoporos Int. 2023 Oct;34(10):1763-1770. doi: 10.1007/s00198-023-06832-5. Epub 2023 Jun 21.
2
Effect of rapid rehabilitation nursing on inflammation and liver function after laparoscopic radical resection of primary liver cancer.快速康复护理对原发性肝癌腹腔镜根治性切除术后炎症及肝功能的影响
Am J Transl Res. 2022 Nov 15;14(11):8156-8165. eCollection 2022.
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Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis.快速康复外科对心脏手术患者围手术期护理的影响:一项荟萃分析。
J Card Surg. 2022 Dec;37(12):5326-5335. doi: 10.1111/jocs.17226. Epub 2022 Nov 30.
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Abaloparatide Increases Lumbar Spine and Hip BMD in Japanese Patients With Osteoporosis: The Phase 3 ACTIVE-J Study.阿巴洛肽增加日本骨质疏松症患者的腰椎和髋部骨密度:3 期 ACTIVE-J 研究。
J Clin Endocrinol Metab. 2022 Sep 28;107(10):e4222-e4231. doi: 10.1210/clinem/dgac486.
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Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update.减重手术围手术期护理指南:术后加速康复(ERAS)学会推荐意见:2021年更新版
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Assessing the role of cortisol in cancer: a wide-ranged Mendelian randomisation study.评估皮质醇在癌症中的作用:广泛的孟德尔随机化研究。
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