加速康复外科理论对老年股骨颈骨折患者髋关节功能、生活质量及术后认知功能的影响

摘要 目的：探讨加速康复外科理论（ERAS）对老年股骨颈骨折（FNF）患者髋关节功能、生活质量以及术后认知功能的影响。方法：选取2018年7月~2019年10月期间我院收治的80例老年FNF患者，按照随机数字表法分为对照组（n=40）和研究组（n=40），对照组给予常规围术期处理，研究组围术期应用ERAS进行处理，比较两组患者围术期指标、髋关节功能、生活质量、术后认知功能及并发症发生情况。结果：研究组术中出血量少于对照组，手术时间、住院时间短于对照组（P<0.05）。研究组术后6个月髋关节功能的优良率为92.50%（37/40），高于对照组的70.00%（28/40）（P<0.05）。两组术后6个月SF-36各维度评分均升高，且研究组高于对照组（P<0.05）。两组术后简易智力状态量表（MMSE）评分均较术前降低，但研究组高于对照组（P<0.05）；研究组的认知功能障碍（POCD）发生率低于对照组（P<0.05）。研究组的并发症总发生率为7.50%（3/40），低于对照组的25.00%（10/40）（P<0.05）。结论：老年FNF患者应用ERAS进行围术期处理，可促进患者术后恢复，减轻认知功能损害及并发症发生率，同时还可有效改善髋关节功能及生活质量。

Effects of Accelerated Rehabilitation Surgery Theory on Hip Function, Quality of Life and Postoperative Cognitive Function in Elderly Patients with Femoral Neck Fracture

ABSTRACT Objective: To investigate the effect of accelerated rehabilitation surgery theory (ERAS) on hip function, quality of life and postoperative cognitive function in elderly patients with femoral neck fracture (FNF). Methods: 80 elderly patients with FNF who were admitted to our hospital from July 2018 to October 2019 were selected, patients were divided into control group (n=40) and study group (n=40) according to the method of random number table. The control group was given routine perioperative treatment. The study group was given ERAS during the perioperative period. The perioperative indicators, hip function, quality of life, postoperative cognitive function and complications situation of the two groups were compared. Results: The intraoperative hemorrhage of the study group was less than that of the control group, and the operation time and hospitalization time were shorter than those of the control group (P<0.05). The excellent and good rate of the study group at 6 months after operation was 92.50% (37/40), which was higher than 70.00% (28/40) of the control group(P<0.05). The scores of SF-36 of all dimensions the two groups at 6 months after operation increased, and those of the study were higher than those of the control group(P<0.05). The simple mental state scale (MMSE) score of the two groups after operation was lower than that before operation, but the study group was higher than the control group (P<0.05). The incidence rate of cognitive impairment (POCD) of the study group was lower than that of the control group (P<0.05). The total incidence rate of postoperative complications of the study group was 7.50% (3/40), which was lower than 25.00% (10/40) of the control group (P<0.05). Conclusion: The elderly patients with FNF used ERAS during perioperative period can promote postoperative recovery, reduce the cognitive impairment and incidence of complications, and which can effectively improve the hip function and quality of life.