Effect Of Early Enteral Nutrition On Elderly Patients With Femoral Neck Fracture After Total Hip Arthroplasty

Objective: To explore the effect of early enteral nutrition on the recovery of elderly patients after total hip arthroplasty.Methods: The elderly(≥ 65 years old)with femoral neck fracture and hypoalbuminemia(serum albumin concentration < 35g/L)who were hospitalized in Hunan people’s Hospital from January 2017 to December2020 were divided into nutritional supplement group and control group according to whether the patients were given enteral nutrition early after operation.Nutrition supplement group was supplemented on the basis of normal diet from the first day after operation,while the control group without any additional nutrition intervention.Detailed records of general patients information,the nutritional indexes(including total protein(TP),albumin(ALB),prealbumin(pre-ALB),hemoglobin(Hb)),as well as biochemical indicators(including creatinine(Cr),blood urea nitrogen(BUN),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TB))before operation,on the first day after operation and on the 10 th day after operation were collected.Compare the differences in Harris hip score,the first time to the ground after operation,wound drainage,hospitalization stay and complication rate after surgery,and analyze its clinical significance.Result: A total of 96 elderly patients were included in the current study,of which 45 were in the nutrition supplement group and 51 were in the control group.There were no significant differences in the general characteristics,the biochemical indicators and nutritional indexes before enteral nutrition intervention.TP,ALB and pre-ALB of nutritional supplement group were significantly higher than those of control group on the 10 th day after operation,and the difference was not statistically significant(P < 0.05).There were no significant differences in Harris hip scores between the nutrition supplement group and the control group 3months after operation,while the Harris scores of the nutrition supplement group were significantly higher than that of the control group at discharge(P < 0.05).The first time to the ground after operation,wound drainage,hospitalization stay and the incidence of complication after surgery were significantly lower than those of the control group(P <0.05).Conclusion: Early enteral nutrition can effectively improve the nutritional status of elderly patients with total hip arthroplasty and hypoproteinemia,reduce the incidence of complications,shorten the length of hospital stay and improve the early functional activities of the artificial hip joint.