[1]毛雷音,傅育红,徐颢庭.加速康复理念下高龄髋部骨折围手术期饮食方案的制定及应用研究[J].中华老年骨科与康复电子杂志,2020,(06):357-363.[doi:10.3877/cma.j.issn.2096-0263.2020.06.008]
　Mao Leiyin,Fu Yuhong,Xu Haoting.A study of perioperative fasting management in aged patients underwent hip fracture surgeries under the concept of ERAS[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(06):357-363.[doi:10.3877/cma.j.issn.2096-0263.2020.06.008]
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加速康复理念下高龄髋部骨折围手术期饮食方案的制定及应用研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2020年06期
页码:
357-363
栏目:
护理园地
出版日期:
2020-12-05

文章信息/Info

Title:
A study of perioperative fasting management in aged patients underwent hip fracture surgeries under the concept of ERAS
作者:
毛雷音; 傅育红; 徐颢庭
214062 无锡市第九人民医院护理部
Author(s):
Mao Leiyin;  Fu Yuhong;  Xu Haoting
Nursing Department, Wuxi?NO .9?People’s Hospital, Wuxi 214062, China
关键词:
加速康复外科;  老年人; 80及以上;  髋骨折;  围手术期护理
Keywords:
Enhanced recovery after surgery;  Aged;  80 and over;  Hip fractures;  Perioperativenursing
DOI:
10.3877/cma.j.issn.2096-0263.2020.06.008
文献标志码:
A
摘要:
目的 探讨在加速康复外科理念下，围手术期高龄髋部骨折患者缩短禁食禁饮时间与术后早期进食进饮的可行性与安全性，制定饮食管理方案并评价其效果。方法 选取2018年12月至2019年12月无锡市第九人民医院收治的150例高龄髋部骨折行人工髋关节置换的患者，入院后2 h内采用营养风险筛查NRS2002评估量表，采用随机数表法进行简单随机分组，将≥3分的130例患者分为干预组和对照组，两组各65例患者。干预组采用本研究制定的围手术期饮食管理方案，对照组采用传统的禁饮食及术后进食方案，比较两组患者术后24 h创伤后应激障碍发生率和谵妄发生率、围手术期口渴饥饿情况、术中误吸及术后恶心、呕吐、腹胀发生率、实际术前禁食禁饮时间及术后进食时间、首次下床时间、平均住院日及患者满意度。结果 与对照组相比，干预组术中误吸及术后恶心、呕吐、腹胀发生率差异无统计学意义。围手术期口渴饥饿情况明显降低、禁食禁饮时间缩短、术后24 h创伤后应激障碍发生率、谵妄发生率、首次下床时间和平均住院日明显缩短，且患者满意度得到提升，差异具有统计学意义（P＜0.05)。结论 应用加速康复理念，制定高龄髋部骨折患者围手术期饮食管理方案安全可行，有效降低了老年患者心理障碍发生率，减少术后并发症，促进患者早日康复并提高了满意度。
Abstract:
Objective To explore feasibility and safety of a novel perioperative fasting plan in aged patients who underwent hip fracture surgeries by reducing fasting time both before & after surgeries under the concept of Enhanced Recovery After Surgery (ERAS). Methods We retrospectively studied all aged (>80y) patients who underwent hip fracture surgeries in our hospital from December 2018 to December 2019 (n=150). All the patients received nutrition?risk?screening with NRS2002 at admission. Those who may need nutrition supports (NRS2002 ≥3) (n=130) were randomly asigned into control group (n=65) and intervention group (n=65). The control group followed traditional perioperative fasting management while the intervention group followed a novel perioperative fasting plan. Actual perioperative fasting time, perioperative thirst & hunger score, incidences of deliration & PTSD 24hrs post-surgery, incidences of ADRs like aspiration or post-surgery nausea& abdominal distension were compared between the two groups. Results There were no significant differences between the two groups in aspiration rates or post-surgery nausea & abdominal distension rates. The intervention group had a significant lower fasting period, perioperative thirst & hunger scores and also lower deliration & PTSD rates 24 h post-surgery. The intervention group had a significant lower hospital stay、accelerated off-bed activities and better degrees of satisfaction. Conclusions The novel perioperative fasting plan in aged patients who underwent hip fracture surgeries under the concept of ERAS was proved feasible and safe, which significantly reduced post-surgery ADRs and hospital stay and increased satisfaction degrees.

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备注/Memo

备注/Memo:
基金项目：无锡市卫计委科研项目（MS201836）
更新日期/Last Update: 2020-12-31