The Analysis Effect Of Eras In The Perioperative Period Of Femoral Intertrochanteric Fracture In Elderly Patients

BackgroundFemoral intertrochanteric fracture is a kind of fracture caused by low energy injury in the elderly.With the development of aging,the life expectancy is prolonged,and its incidence is on the rise.Intertrochanteric fractures are preferred because of their high mortality.Enhanced recovery after surgery(ERAS)refers to the optimization of perioperative measures to alleviate the body’s stress response,reduce related complications,promote early recovery of organ function,shorten hospital stay,and restore the patient’s body to preoperative status as soon as possible.The use of enhanced recovery after surgeryon concept to guide the application of intertrochanteric fractures in the perioperative period has a positive effect on the rehabilitation of patients.ObjectiveThe concept of enhanced recovery after surgery was proposed by Danish surgeon Kehlet in 1997.It has been 21 years since the concept,and there are few related researches in trauma orthopedics.This study optimizes the perioperative period of the elderly femoral intertrochanteric fractures under the guidance of the enhanced recovery after surgery concept,and analyzes the clinical application effect of the enhanced recovery after surgery concept by comparing the traditional treatment modes.MethodsThe clinical data of elderly patients with intertrochanteric fractures treated in the Department of Trauma and Orthopaedics in our hospital from January 2017 to December 2018 were selected.The inclusion criteria and exclusion criteria were selected.According to the treatment mode,they were divided into enhanced recovery after surgery group(hereinafter referred to as ERAS group).The clinical data of the two groups of patients were retrospectively analyzed with the conventional model routine group(hereinafter referred to as the conventional group).The conventional group was treated according to the traditional treatment plan,and the ERAS group added a series of related measures of perioperative period of rapid rehabilitation surgery(ERAS)based on traditional treatment.The operation time,intraoperative blood loss,blood transfusion volume,postoperative drainage volume,postoperative drainage tube removal time,postoperative hospital stay,and 1 week postoperative,2 weeks postoperative,and 4 weeks postoperative were recorded in the ERAS group and the conventional group hip function Harris score.ResultsThe operation time of the ERAS group [(52.29±5.31)min] was lower than that of the conventional group [(55.23±5.58)min];the intraoperative blood loss of the ERAS group [(170.19±11.50)m1] was lower than that of the conventional group] [(176.60±14.52)];postoperative drainage volume in the ERAS group [(92.58±10.49)ml] was lower than that in the conventional group [(98.47±11.68)ml];postoperative drainage tube removal time in the ERAS group [(24.90± 2.80)h] was lower than the conventional group postoperative drainage tube removal time [(26.32± 2.60)h];the ERAS group transfusion volume [(1.70±0.84)U] was lower than the conventional group transfusion volume [(2.21±0.91)U];The postoperative hospital stay in the ERAS group [(7.82±1.74)d] was less than the postoperative hospital stay [(9.13±2.07)d](P<0.05 or 0.01).The hip function Harris score [(49.36±3.87)],[(59.73±3.78)],[(68.95±4.03)] in the ERAS group at 1 week,2 weeks,and 4 weeks was superior to the conventional group [(47.41±4.65)minutes,[(57.19±4.27)minutes],[(65.78±4.05)minutes](P<0.05 or 0.01).ConclusionsThe enhanced recovery after surgery concept is superior to the traditional treatment mode in the perioperative period of the elderly intertrochanteric fractures.The enhanced recovery after surgery concept can shorten the operation time,reduce the intraoperative blood loss and blood transfusion,and reduce the intraoperative intertrochanteric fracture.Postoperative drainage,early removal of the drainage tube,shorten the length of hospital stay,promote hip function recovery,accelerate the postoperative rehabilitation of elderly patients with intertrochanteric fractures,it is worthy of popularization and application.