绿色通道多学科诊疗模式提高高龄股骨转子间骨折的临床疗效

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Abstract Objective To study the clinical effect of green channel and multi-disciplinary diagnosis and treatment modeon the elderly patients with intertrochanteric fracture of femur.Methods The clinical data of 322 elderly patients (≥70 years old) with intertrochanteric fracture of femur treated by two kinds of operation modes were statistically analyzed.According to the diagnosis and treatment modes，they were divided into two groups：the priority group (green channel multidisciplinary diagnosis and treatment mode，160 cases) and the routine group (routine diagnosis and treatment mode，162 cases).The waiting time for operation，operation time，bleeding volume，length of stay and postoperative complications were compared between the two groups.Results The waiting time for operation of patients was significantly different between priority group(38.8 h) and routine group(132.4 h，P＜0.01)，and the hospital stay of patients was significantly different between priority group(6.4±2.1)d and routine group(12.3±6.2)d，P＜0.01).There was no significant difference in the operation time and bleeding volume between the two groups(P＞0.05).The complications of patients in the priority group(30/160，18.8%) was significantly lower than that in the routine group(91/162，56.1%；P＜0.01).The incidences of pulmonary infection，deep vein thrombosis(DVT)，delirium and pressure sore of patients in the priority group was significantly lower than that in the routine group 5.6%(9/160) VS 20.4%(33/162)，4.4%(7/160) VS 12.3%(20/162)，3.7%(6/160) VS 8.6%(14/162)，1.3%(2/160) VS 6.8%(11/162)，P＜0.05.There was no significant difference in the incidences of respiratory failure，sudden death，heart failure，pulmonary embolism and cerebral infarctionbetween the two groups(P＞0.05).Conclusion Through the establishment of green channel and multi-disciplinary diagnosis and treatment mode，early operation，if possible，can significantly reduce the hospitalization time and postoperative complications of the elderly patients with intertrochanteric fracture of femur，which is of great clinical significance for the standardized treatment of hip fracture in the elderly.

Key words： green channel multidisciplinary diagnosis and treatment mode elderly intertrochanteric fracture of femur

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