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| Effect of operation opportunity on prognosis of elderly hip fracture |
| ZHUO Zeming XING Shi WANG Hejie CHEN Lixi▲ WANG Yuan |
| Orthopedic Medical Center, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Hainan Province, Haikou 572000, China |
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Abstract Objective To study the effect of operation opportunity on the prognosis of elderly hip fracture. Methods A total of 112 elderly patients with hip fracture who were enrolled in Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from March 2018 to April 2019 were selected as the observation objects and they were divided into study group and control group according to operation opportunity, with 56 patients in each group. The operation was performed within 48 hours after fracture in the study group, and the operation was performed within 48-72 hours after the fracture in the control group. The amount of blood loss, operation, hospitalization and fracture healing time were compared between the two groups, and the incidence of complications (vascular nerve injury, pulmonary infection, bone nonunion) were compared between the two groups. The flexion and abduction activity of hip joint were measured before and after operation and the visual analog scale (VAS), hip joint function (Harris) score, quality of life (QOL) score and clinical symptom score were investigated. Follow-up of one year, the mortality rate of the two groups was recorded and the operation results of the two groups were compared. Results There was no significant difference in the operation time between the two groups (P ＞ 0.05). The amount of blood loss in the study group were less than that in the control group, hospitalization and fracture healing time in the study group were lower than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The total incidence of complications in the study group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). There were no statistically significant differences in hip flexion, abduction activity, Harris score, VAS, QOL score and clinical symptom score between the two groups before operation (P ＞ 0.05). After operation, hip flexion, abduction activity, Harris score and QOL score in both groups were higher than before operation, while VAS and clinical symptom score were lower than before operation. In the study group, hip flexion, abduction activity, Harris score and QOL score were higher than those in the control group, while VAS and clinical symptom score were lower than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The mortality rate of one year after operation in the study group was lower than that in the control group, the difference was statistically significant (P ＜ 0.05). Conclusion Early implementation of operation after hip fracture in elderly patients has more prominent effect, which can quickly improve the hip ability of patients, reduce the length of treatment, reduce the pain of patients, quickly relieve the corresponding symptoms, promote the recovery of mobility, prevent serious complications, and improve the quality of life.
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[1] 赵建文，王晓伟，刘智，等.手术时机的选择对90岁以上髋部骨折患者预后的影响[J].中国骨与关节杂志，2020， 9（5）：390-393.
[2] Sanz-Reig J，Salvador Marín J，Ferrández Martínez J，et al. Prognostic factors and predictive model for in-hospital mortality following hip fractures in the elderly [J]. Chin J Traumatol，2018，21（3）：163-169.
[3] 张海军，李仲瑞，严越茂，等.老年患者髋部骨折不同手术时机的选择及疗效分析[J].局解手术学杂志，2018，27（12）：895-898.
[4] 刘青春，陈云丰.探讨手术时间的差异对老年髋部骨折临床疗效的影响[J].创伤外科杂志，2018，20（8）：566-570.
[5] 李涧，常留辉，顾颀，等.老年髋部骨折48小时内手术的疗效分析[J].中华骨科杂志，2019，39（17）：1037-1043.
[6] 陈愛民.老年髋部骨折手术不同时机与预后的关系[J].中国伤残医学，2018，26（14）：93-94.
[7] 万伦.对98例老年髋部骨折患者进行急诊手术与择期手术的效果对比[J].当代医药论丛，2020，18（8）：20-22.
[8] 视觉模拟评分法（VAS）[J].中国微侵袭神经外科杂志，2004，9（11）：483-483.
[9] Fazal MA，Bagley C，Garg P. Predictors for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary nailing [J]. Chin J Traumatol，2018，21（1）：16-19.
[10] 张少华，刘建军，郎新庆，等.两种生活质量量表评估老年人群健康状况的效果及价值[J].国际老年医学杂志，2020，41（4）：259-261，269.
[11] Yang S，Liu Y，Yang T，et al. Early Clinical Efficacy Comparison Study of Gamma3 Nail，Percutaneous Compression Plate（PCCP）and Femoral Head Replacement（FHR）Treatment on Senile Unstable Intertrochanteric Fractures [J]. J Invest Surg，2018，31（2）：130-135.
[12] 姜涛.老年患者髋部骨折不同手术时机的选择及疗效分析[J].国际感染杂志：电子版，2018，7（3）：74-76.
[13] 刘青春，陈云丰.手术时机与老年髋部骨折患者术后并发症发生及预后关系研究[J].创伤与急危重病医学，2018，6（4）：258-260.
[14] Wang XJ，Lu Li，Zhang ZH，et al. Ilioinguinal approach versus Stoppa approach for open reduction and internal fixation in the treatment of displaced acetabular fractures：A systematic review and meta-analysis [J]. Chin J Traumatol，2017，20（4）：229-234.
[15] 刘功稳，高焱，徐又佳.髋部骨质疏松性骨折48小时手术的临床意义[J].中华骨科杂志，2019，39（17）：1096-1100.
[16] 南海云.老年髋部骨折手术时机选择与术后疗效观察[J].基层医学论坛，2019，23（14）：1977-1978.
[17] 雷利国，白彬峰.高龄髋部骨折患者手术时机及住院时间的相关因素分析[J].临床医学研究与实践，2018，3（17）：108-109.
[18] 游月烊，孙凯，严敏.手术时机对老年髋部骨折患者术后病死率影响的研究进展[J].中华创伤杂志，2020，36（1）：58-62.
[19] Baer M，Neuhaus V，Pape HC，et al. Influence of mobilization and weight bearing on in-hospital outcome in geriatric patients with hip fractures [J]. SICOT-J，2019，5（4）.
[20] 熊冬波.不同手术时机对老年人髋部骨折治疗效果的影响[J].当代医学，2018，24（24）：144-145.
[21] 韦家志，王洪，郭万兴.手术时间差异对老年髋部骨折患者疗效的影响[J].中国现代药物应用，2019，13（24）：11-13.
[22] 王晓伟，孙天胜，刘智，等.老年髋部骨折的手术时机选择与预后分析[J].中华创伤骨科杂志，2020，22（3）：206-211.
[23] 马小军.不同手术时机治疗98例老年髋部骨折患者的临床效果分析[J].中国现代医生，2019，57（20）：82-85.
[24] 陈小磊，李翠莲，李笑芬，等.高龄髋部骨折患者不同手术时机术后谵妄发生情况研究[J].中国医学创新，2019， 16（16）：23-25.
[25] 孙跃先，于晶，朱海夫，等.手术时机对老年髋部骨折患者的康复效果影响观察[J].中国医药科学，2020，10（18）：199-201，213.
[26] 杨占东，李庆荣，张磊，等.不同手术时机对老年人髋部骨折治疗效果的影响[J].宁夏医科大学学报，2016，38（12）：1450-1452. |
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