摘要
目的观察多学科综合治疗(MDT)≥80岁老年人股骨粗隆间不稳定骨折的临床疗效。方法将78例2013年1月至2016年7月我科治疗的≥80岁股骨粗隆间不稳定骨折病人随机分为2组,学科综合治疗组35例(MDT组),传统模式治疗组(对照组)43例;参照Harris评分对2组疗效进行比较分析,同时对比2组的手术率、术前等待时间、总住院天数、骨折中晚期并发症发生率及1年内死亡率。结果 MDT组病人术后6个月髋关节Harris评分高于对照组病人(P<0.05);MDT组的手术率为85.7%(30/35),明显高于对照组的23.3%(10/43);MDT组病人的术前等待时间[(1.77±0.82)d]少于对照组[(5.50±2.37)d](P<0.05);MDT组病人的总住院天数[(15.00±2.76)d]短于对照组[(21.70±6.48)d](P<0.05);MDT组的骨折中晚期并发症发生率为20%(7/35),明显低于对照组的90.7%(39/43)(P<0.05);MDT组1年内死亡率为14.3%(5/35),明显低于对照组的69.8%(30/43)。结论 MDT可提高高龄股骨粗隆间不稳定骨折病人的手术率及临床疗效,减少病人的术前等待时间及住院总天数,并可降低骨折中晚期并发症的发生率及1年内的死亡率,值得临床推广应用。
Objective To observe the clinical efficacy of multidisciplinary treatment（ MDT） for unstable intertrochanteric fractures in the elderly.Methods 78 patients aged 80 years old and over with unstable intertrochanteric fracture of the femur in our department from January 2013 to July 2016 were randomly divided into MDT group（ n = 35） and control group（ n = 43,without MDT）.The curative effect was assessed by Harris hip score and compared between two groups.At the same time,the operation rate,the preoperative waiting time,total hospitalization days,the incidence rate of late complications of fractures and mortality within 1 year were compared between two groups.Results The Harris hip score in the MDT group was higher than that in the control group 6 months after operation（ P 〈0.05）; The operation rate of MDT group（ 85.7%,30/35） was significantly higher than that of control group（ 23.3%,10/43）; The preoperative waiting time in the MDT group（ 1.77 ± 0.82 d） was shorter than that in the control group（ 5.50± 2.37 d）（ P 〈0.05）; The total hospitalization days in the MDT group（ 15.00 ±2.76 d） was shorter than that in the control group（ 21.70±6.48 d）（ P〈0.05）; The incidence rate of late complications of fractures in MDT group（ 20%,7/35） was significantly lower than that of control group（ 90.7%,39/43）; The mortality rate in MDT group within 1 year（ 14.3%,5/35） was significantly lower than that in control group（ 69.8%,30/43）.Conclusions MDT can improve the operation rate and clinical effect of patients with unstable intertrochanteric fractures,shorten the preoperative waiting time and total hospitalization days,and can reduce the incidence rate of late complications of fracture and mortality within 1 year,it is worthy of promotion application in clinical.
作者
陈永鑫
何斌
王云华
范磊
王伯尧
秦虎
刘军
CHEN Yong-xin, HE Bin, WANG Yun-hua, FAN Lei, WANG Bo-yao, QIN Flu, LIU Jun.(Department of Orthopaedics, the Second Affiliated Hospital of Nanjing Medcial University, Nanjing 210011, Chin)
出处
《实用老年医学》
CAS
2018年第3期221-225,共5页
Practical Geriatrics
关键词
多学科
综合治疗
股骨粗隆间骨折
高龄
muhidisciplinary
comprehensive treatment
intertrochanteric fracture of femur
aged
