Perioperative Treatment Of Elderly Patients With Intertrochanteric Fractures With ERAS

Objective:Through this clinical study,we analyzed the research progress and clinical efficacy of the concept of enhanced recovery aftersurgery(ERAS)in the perioperative treatment of elderly patients with intertrochanteric fractures,and explored the related factors affecting the clinical efficacy of RRS in elderly patients with intertrochanteric fractures.Methods:We collected the patients who were diagnosed with Elderly Femoral Intertrochanteric Fracture(EFIF)by imaging and treated with Proximal Femoral Nail Anti-rotation(PFNA)intramedullary fixation in Hechi Municipal People’s Hospital.They were screened by inclusion criteria.Forty-eight patients were collected as the ERAS group from July 2021 to August 2022,and 42 patients from July 2020 to July 2021 as the routine control group.The general information was comparable.Two groups of data were retrospectively studied.The ERAS nursing pathway included education plan,nutrition management,diet management,sleep management,and pain selection management.Anesthesia,bleeding control,body temperature management,infection prevention,anesthesia management,drainage tube infusion management,nausea and vomiting control,and activity management.The experimental research of the routine control group was conducted according to the traditional nursing approach.Anti-infection,anti-coagulation and other measures were taken during the perioperative period to prevent complications.General data such as gender,age,and basic diseases of patients in the two groups were collected.Data such as blood loss during the operation,blood transfusion during and after the operation,hospital stay,and complication rate were recorded and collected as well as the visual analogue scale on the 1st,4th,and 1st week after the operation of the two groups.VAS)and activities of daily living(ADL)scores on the 1st day,1st week,and 3rd week after surgery as well as Harris hip score(HHS)scores on the 1st,2nd,3rd week,and 3rd month after surgery.Statistical analysis was performed on the collected data.The experimental data were expressed as(x ± s).The mean values of the two samples were compared with t test,and the sample rates of the two samples were compared with X2 test to determine the mean and standard deviation as well as the minimum and maximum values of all results.P<0.05 were considered statistically significant.Results:(1)The age,gender,distribution of diseased limbs and blood transfusion volume of patients in 1)ERAS group and conventional group were statistically analyzed(P>0.05).The postoperative complications of patients in two groups were statistically analyzed(P=0.313,>0.05).There was no statistical significance in the data.(2)The differences in bleeding volume(t=4.042,P<0.01),operation time(t=5.067,P<0.01),hospital stay(t=3.199,P=0.002)and postoperative complications(P=0.031)between the ERAS group and the conventional group were statistically significant.The specific comparison showed that the average value of the conventional group was significantly higher than the average value of the ERAS group.The VAS scores on the 1st day,4th day and 1st week in different groups of rats between the ERAS group and the conventional group showed statistically significant differences(P<0.05),as well as the specific comparison differences.It can be seen that the average values of the data in the three groups of the conventional group were significantly higher than the average values in the ERAS group.(3)The difference of ADL score on the first day between the ERAS group and the conventional group was statistically significant(t=-4.043,P<0.01),and the specific comparison difference showed that the conventional group was significantly lower than the average of the ERAS group.However,the difference of ADL score in the first and third weeks between the two groups was P>0.05,and there was no statistical significance.The differences of Harris scores among the three groups of data between the ERAS group and the conventional group were statistically significant(t=-4.043,P<0.05),and the specific comparison difference indicated that the conventional group was significantly lower than the average value of the ERAS group.Conclusion:The application of ERAS concept in elderly patients with intertrochanteric fracture is relatively to the traditional treatment mode.Compared with the traditional treatment mode,ERAS concept not only reduces the amount of bleeding and operation time,but also reduces the use of drugs and hospital stay,thus speeding up the patients’postoperative rehabilitation,improving the patients’ quality of life after rehabilitation,reducing the related costs of hospitalization,and improving the patients’ satisfaction during hospitalization.Therefore,we should strengthen the clinical practice of ERAS method and promote the promotion between medical care and nursing.