多学科综合治疗老年股骨颈骨折合并慢性肾功能衰竭的临床观察

doi:10.3969/j.issn.1003-9198.2022.02.008

摘要/Abstract

摘要： 目的探讨多学科综合治疗(MDT)应用于老年股骨颈骨折合并慢性肾功能衰竭(肾衰)的临床疗效。方法收集南京医科大学第二附属医院2017年2月至2020年12月收治的44例老年股骨颈骨折合并慢性肾衰病人,随机分为MDT组(n=24)和传统治疗组(n=20)。采用Harris评分评定疗效。统计2组的手术率,以及手术病人的术前等待时间、总住院时间、骨折早中期并发症发生率、术后肾功能恶化发生率,并进行组间比较。结果所有手术病人随访至2021年6月。MDT组手术率显著高于传统治疗组(83.3%比30.0%,P＜0.05);MDT组术前等待时间、总住院时间明显低于传统治疗组 (P＜0.05),术后6个月Harris评分高于传统治疗组(P＜0.05)。MDT组术后肾功能恶化的发生率、骨折早中期并发症发生率低于传统治疗组 (P＜0.05)。结论 MDT模式有助于提高老年股骨颈骨折合并慢性肾衰病人的手术率及临床疗效,并降低手术病人骨折早中期并发症的发生率及术后肾功能恶化的发生率,缩短术前等待时间及住院时间,疗效肯定,具有良好的社会价值。

关键词: 多学科综合治疗, 股骨颈骨折, 肾功能不全, 老年人

Abstract: Objective To explore the clinical effect of multidisciplinary treatment (MDT) in the elderly patients with femoral neck fracture complicated with chronic renal failure. Methods A total of 44 elderly patients with femoral neck fracture complicated with chronic renal failure treated in the Second Affiliated Hospital of Nanjing Medical University from February 2017 to December 2020 were randomly divided into two groups: the MDT group (n=24) and the traditional treatment group (n=20). The curative effect was evaluated by Harris score. The curative effect, the waiting time before operation, the total hospital stay, the incidence rate of early and medium-term complications of fracture and the incidence rate of deterioration of renal function were recorded and compared between the MDT group and the traditional treatment group. Results All the patients were followed up to June 2021. The operation rate of the MDT group was significantly higher than that of the traditional treatment group (83.3% vs. 30.0%, P＜0.05);The preoperative waiting time and the total hospitalization days in the MDT group were significantly shorter than those in the traditional treatment group (P＜0.05);The Harris hip score in the MDT group was higher than that in the traditional treatment group 6 months after operation (P＜0.05);After operation,The incidence rate of deterioration of renal function after operation and the incidence rate of early and medium-term complications of fractures in the MDT group were significantly lower than those in the traditional treatment group (P＜0.05). Conclusions MDT mode is helpful to increase the operation rate and improve the clinical effect of the elderly patients with femoral neck fracture complicated with chronic renal failure, which could reduce the incidence of early and medium-term complications of fracture and the deterioration of renal function after operation, and shorten the waiting time before operation and hospitalization time.

Key words: multidisciplinary treatment, femoral neck fracture, renal insufficiency, aged

中图分类号:

R 681.8

郑宏瑞, 范磊, 何斌, 秦虎, 沈亚骏, 王云华. 多学科综合治疗老年股骨颈骨折合并慢性肾功能衰竭的临床观察[J]. 实用老年医学, 2022, 36(2): 138-141.

ZHENG Hong-rui, FAN Lei, HE Bin, QIN Hu, SHEN Ya-jun, WANG Yun-hua. Clinical observation of multidisciplinary treatment for femoral neck fracture complicated with chronic renal failure in the elderly[J]. Practical Geriatrics, 2022, 36(2): 138-141.

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