目的:探讨加速康复外科(ERAS)对髋部骨折患者围手术期愈合及应激反应的影响。
方法:对西南医科大学附属医院2022年1月至2023年8月收治的86例髋部骨折患者的病历资料进行回顾性分析。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。髋关节功能,疼痛程度,应激反应,骨折愈合时间,并发症的发生率,比较两组患者的护理满意度。
结果:护理后,两组的Harris评分都显著增加,研究组评分明显高于对照组(P<0.05)。皮质醇和肾上腺素的水平,两组的视觉模拟量表评分均显着下降,研究组水平显著降低(P<0.05)。此外,研究组骨折愈合时间明显缩短(P<0.05),护理满意度较高(P=0.014),并发症发生率较低(P=0.028)。Logistic回归分析显示,年龄,潜在的疾病,护理方法,情绪障碍,和手术时机是影响护理后结局的独立因素。
结论:ERAS模式能有效缓解疼痛,改善髋关节功能,减少骨折愈合时间和并发症,缓解应激反应,加速髋部骨折患者的术后恢复。值得在临床实践中应用和推广。
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.
CONCLUSIONS: 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.