叶征 陈舰

[摘要] 目的 探讨损伤控制理论对老年人髋关节骨折患者疾病治愈率及并发症发生率的影响。 方法 选取同济大学附属普陀人民医院2015年1月～2017年5月145例老年髋关节骨折患者，采用抽签法随机分为两组，对照组采用常规的治疗方法，治疗组在对照组常规治疗方法基础上采用损伤控制理论。比较两组患者治疗效果、生活质量评分、焦虑自评量表（SAS）和抑郁自评量表评分（SDS）、牛津残障评分（OHS功能量表评分）和并发症发生情况。 结果 治疗组治疗优良率显著高于对照组，差异有统计学意义（P < 0.05）。治疗组的生活质量评分均高于对照组，差异有统计学意义（P < 0.05）。护理干预后两组患者SAS和SDS评分在均显著低于护理干预前，且治疗组评分低于对照组，差异有统计学意义（P < 0.05）。两组患者护理干预前OHS量表评分差异无统计学意义（P > 0.05），治疗组护理干预后评分低于对照组，差异有统计学意义（P < 0.05）。治疗组的并发症发生率低于对照组，差异有统计学意义（P < 0.05）。 结论 老年髋关节骨折患者采用损伤控制理论可以加快愈合时间，减少患者疼痛，减少并发症的发生，具有较高的临床价值。

[关键词] 损伤控制理论；髋关节骨折；老年；治愈率；并发症

[中图分类号] R683.42 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0083-04

[Abstract] Objective To investigate the effect of damage control theory on the cure rate and complication rate of elderly patients with hip fracture. Methods From January 2015 to May 2017， 145 elderly patients with hip fracture were selected and randomly divided into two groups from Putuo People′s Hospital Affiliated to Tongji University. The control group was received conventional treatment and the treatment group was received the injury control theory on the basis of conventional treatment. The efficacy， quality of life， self-rating anxiety scale （SAS） and self-rating depression scale （SDS）， Oxford disability scale （OHS scale） and complication were compared. Results The excellent and good rate of the treatment group was significantly higher than the control group， the difference was statistically significant （P < 0.05）. The scores of quality of life of the treatment group were higher than the control group， the differences were statistically significant （P < 0.05）. SAS and SDS scores of the two groups after treatment were significantly lower than before treatment， and the treatment group scores were lower than the control group， the differences were statistically significant （P < 0.05）. There were no significant differences between the two groups in the OHS scores before treatment， and the scores of the treatment group after treatment were lower than those of the control group （P < 0.05）. The incidence of complications in the treatment group was lower than that in the control group， the difference was statistically significant （P < 0.05）. Conclusion Adopting the theory of injury control in elderly patients with hip fracture can speed up the healing time， reduce the pain and the incidence of complications， which has high clinical value.

[Key words] Damage control theory； Hip joint fracture； Old age； Cure rate； Complication

髖骨骨折在老年人中发病率较高，若老年人出现髋骨骨折症状后应立即采取手术治疗[1-3]。据临床统计若髋骨骨折不能及早治疗可能会引发一系列并发症，甚至会出现严重感染导致死亡[4-6]。如今为更好治疗老年髋骨骨折在手术过程中联合应用损伤控制理论，该理论是指在患者出现严重创伤时会先保证患者处于清醒状态，当病情稳定后采取合适的治疗方法[7-8]。目前在临床手术中采用损伤控制理论后已经取得较好的临床治疗效果，显著改善了患者的预后情况[9]。本研究选取同济大学附属普陀人民医院（以下简称“我院”）2015年1月～2017年5月145例老年髋关节骨折患者，采用损伤控制理论联合常规治疗，从而探讨该理论在老年髋关节骨折中辅助治疗效果，为临床治疗提供更为科学的临床依据。……