Objective: To investigate the effectiveness of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric patients with hip fractures.
Methods: The clinical data of 489 geriatric patients with hip fractures (femoral neck fracture and intertrochanteric fracture) between January 1st 2016 and January 1st 2018 was retrospectively analyzed. Among them, 279 patients were treated with the multidisciplinary doctor-nurse collaboration care (observation group) and 210 patients were treated with the conventional therapeutics and nursing care (control group). There was no significant difference in gender, age, cause of injury, type and classification of fracture, the interval between injury and admission, and Charlson index between the two groups ( P>0.05). The surgery rates, time from hospitalization to operation, length of stay, and the incidences of perioperative complications were compared between the two groups.
Results: The surgery rate was 90.32% (252/279) in observation group and 80.48% (169/210) in control group, showing significant difference between the two groups ( χ 2=9.703, P=0.002). The time from hospitalization to operation and length of stay in observation group [(5.39±2.47), (10.56±3.76) days] were significant shorter than those in control group [(6.13±2.79), (12.27±3.11) days] ( t=-3.075, P=0.002; t=-5.330, P=0.000). The incidence of respiratory complications was 46.15% in control group and 30.56% in observation group; the incidence of cardiovascular system complications was 69.23% in control group and 51.19% in observation group; the incidence of cerebrovascular system complications was 20.12% in control group and 11.11% in observation group; the incidence of deep venous thrombosis was 40.24% in control group and 25.40% in observation group. The incidences of perioperative complications were significantly lower in observation group than in control group ( P<0.05).
Conclusion: Multidisciplinary doctor-nurse collaboration team is conducive not only to improve the surgery rates, but also to reduce perioperative complications as well as shorten the length of stay and preoperative waiting time.
目的: 探讨多学科医护协作模式在老年髋部骨折围术期的应用效果。.
方法: 回顾分析 2016 年 1 月 1 日—2018 年 1 月 1 日收治且符合选择标准的 489 例老年髋部骨折（股骨颈骨折和股骨转子间骨折）患者临床资料，其中 279 例患者采用多学科医护协作诊疗模式（观察组），210 例患者采用传统创伤骨科诊疗模式（对照组）。两组患者性别、年龄、致伤原因、骨折类型、骨折分型、受伤至入院时间及 Charlson 指数比较，差异均无统计学意义（ P>0.05）。比较两组手术治疗率、手术患者术前等待时间和住院时间，以及围术期并发症发生率。.
结果: 观察组 252 例（90.32%）、对照组 169 例（80.48%）患者接受手术治疗，两组手术治疗率差异有统计学意义（ χ 2=9.703， P=0.002）。观察组术前等待时间及住院时间分别为（5.39±2.47）、（10.56±3.76） d，较对照组的（6.13±2.79）、（12.27±3.11）d 明显缩短（ t=−3.075， P=0.002； t=−5.330， P=0.000）。观察组及对照组呼吸系统并发症发生率分别为 30.56%、46.15%，心血管系统并发症发生率分别为 51.19%、69.23%，脑血管疾病发生率为 11.11%、20.12%，下肢深静脉血栓形成发生率分别为 25.40%、40.24%；观察组上述各种并发症发生率均明显低于对照组，差异均有统计学意义（ P<0.05）。.
结论: 应用多学科医护协作诊疗模式可以提高老年髋部骨折患者手术率，缩短术前等待时间和住院时间，降低围术期并发症发生风险。.
Keywords: Multidisciplinary team; doctor-nurse collaboration; geriatric hip fracture; perioperative period.