加速康复外科理念在老年股骨转子间骨折PFNA术后增强恢复理念的跨学科护理应用

Interdisciplinary Nursing Application of the Enhanced Recovery after Surgery (ERAS) Concept in Elderly Patients with Intertrochanteric Femoral Fractures Following PFNA Surgery

摘要: 目的：评估基于加速康复外科(Enhanced Recovery after Surgery, ERAS)理念构建的跨学科护理模式在老年股骨转子间骨折患者PFNA围手术期管理中的应用效果。方法：采用前瞻性、单中心、随机、评估者盲法对照研究设计，纳入2024年10月至2025年10月新疆医科大学第六附属医院创伤骨一科收治并接受PFNA治疗的老年股骨转子间骨折患者70例，按1:1随机分为试验组和对照组，每组35例。对照组接受常规围手术期护理，试验组在此基础上实施ERAS理念下的跨学科护理。比较两组Harris髋关节评分(HHS)、Barthel指数(BI)、贝克焦虑量表(BAI)、视觉模拟疼痛评分(VAS)、Caprini血栓风险评分及并发症发生情况。结果：两组基线资料差异无统计学意义(P > 0.05)。术后1周、1个月及6个月，试验组HHS和BI均高于对照组(P < 0.05)；BAI在各时间点组间差异均无统计学意义；术后1个月试验组VAS和Caprini评分低于对照组(P < 0.05)。结论：基于ERAS理念的跨学科护理有助于改善老年股骨转子间骨折PFNA术后髋关节功能和日常生活能力，并可能减轻术后疼痛、降低血栓风险，值得在围手术期护理中进一步推广。

Abstract: Objective: The evaluation of the application efficacy of an interdisciplinary nursing model based on the Enhanced Recovery after Surgery (ERAS) concept in the perioperative management of PFNA for elderly patients with intertrochanteric femoral fractures. Methods: Using a prospective, sin-gle-center, randomized, investigator-blind controlled study design, 70 elderly patients with inter-trochanteric femoral fractures treated with PFNA at the First Department of Traumatic Orthopedics, Sixth Affiliated Hospital of Xinjiang Medical University between October 2024 and October 2025 were enrolled and randomly assigned in a 1:1 ratio to either the experimental group or the control group (n = 35 each). The control group received conventional perioperative care, while the experi-mental group additionally received interdisciplinary nursing care guided by the ERAS concept. The two groups were compared regarding Harris Hip Score (HHS), Barthel Index (BI), Beck Anxiety Scale (BAI), Visual Analog Pain Scale (VAS), Caprini Thrombosis Risk Score, and incidence of complica-tions. Result: No statistically significant differences were observed between the two groups in base-line parameters (P > 0.05). At 1 week, 1 month, and 6 months postoperatively, the trial group ex-hibited higher HHS and BI scores than the control group (P < 0.05); no statistically significant dif-ferences were noted in BAI scores across time points between the groups; however, at 1 month postoperatively, the trial group showed lower VAS and Caprini scores compared to the control group (P < 0.05). Conclusion: Interdisciplinary nursing based on the ERAS concept helps improve hip joint function and daily living abilities in elderly patients with intertrochanteric femoral fractures after PFNA surgery, while potentially alleviating postoperative pain and reducing thrombosis risk. It warrants further promotion in perioperative care.