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| 麻醉科医师术前受邀会诊与老年患者髋部手术后早期并发症的相关性 |
| Correlation of preoperative anesthesia consultation with early postoperative complications in elderly patients undergoing hip surgery |
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| DOI：10.12089/jca.2021.10.010 |
| 中文关键词: 麻醉 会诊 老年 髋部手术 住院时间 并发症 |
| 英文关键词: Anaesthesia Consultation Aged Hip surgery Hospital stays Complication |
| 基金项目: |
| 作者 | 单位 | E-mail | | 张贝贝 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | | | 贾佳 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | | | 张加强 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | | | 马丽斌 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | | | 陈艺 | 450003,郑州市,河南省人民医院,郑州大学人民医院临床科研服务中心 | | | 孟凡民 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | | | 张伟 | 450003,郑州市,河南省人民医院,郑州大学人民医院麻醉与围术期医学科 | myhope2005@163.com |
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| 中文摘要: |
目的 探讨麻醉科医师术前受邀会诊与老年患者髋部手术后早期并发症的相关性。
方法 采用倾向性评分匹配（PSM）法回顾性分析2019年1—12月行髋部手术患者100例，男36例，女64例，年龄≥65岁，ASA Ⅲ或Ⅳ级。根据术前是否接受由外科医师提交会诊申请并由麻醉科高年资主治医师执行的正式会诊，将患者分为两组：受邀会诊组（会诊组）和非受邀会诊组（对照组），每组50例。收集性别、年龄、BMI、ASA分级、年龄校正的Charlson合并症指数（aCCI）、麻醉方法、手术时间、麻醉时间、手术出血量、术前等待时间、术前住院时间、术后住院时间、总住院时间、术后1个月并发症等数据。比较两组一般情况、术中情况、住院时间和术后并发症等。
结果 两组性别、年龄、BMI、ASA分级和aCCI差异无统计学意义。会诊组椎管内麻醉比例明显高于对照组，术前等待时间、术前住院时间明显长于对照组，术后住院时间明显短于对照组（P<0.05）。两组手术时间、麻醉时间、出血量和总住院时间差异无统计学意义。会诊组术后并发症发生率明显低于对照组（P<0.05）。
结论 麻醉科医师术前受邀会诊与缩短老年患者髋部手术后住院时间及减少术后早期并发症相关。 |
| 英文摘要: |
Objective To investigate the correlation of preoperative anesthesia consultation with early postoperative complications in elderly patients undergoing hip surgery.
Methods A retrospective analysis of 100 patients undergoing hip surgery from January 2019 to December 2019, 36 males and 64 females, aged ≥ 65 years, ASA physical status Ⅲ or Ⅳ, was performed by a propensity score matching (PSM) method. All the patients were divided into 2 groups: invited consultation group (consultation group) and uninvited consultation group (control group), 50 patients in each group, according to whether they received a formal consultation which submitted by the surgeon and conducted by the senior attending anesthesiologist before surgery or not. The demographic characteristic, ASA physical status, anesthesia method, operation time, anesthesia time, preoperative complications, age adjusted Charlson comorbidity index (aCCI), perioperative bleeding volume, postoperative complications during one month after the operation, preoperative hospitalization, postoperative hospitalization, and the total length of hospital stay were analyzed. The operative parameters, length of hospital stay, and postoperative complications between the two groups were compared.
Results There were no significant differences in gender, age, BMI, ASA physical status and aCCI index between the two groups. The proportion of spinal anesthesia in consultation group was significantly higher than that in control group, the preoperative waiting time and hospitalization time were significantly longer than that in control group, and the postoperative hospitalization time was significantly shorter than that in control group (P < 0.05). There were no significant differences in operation time, anesthesia time, blood loss and total hospital stay between the two groups. The incidence of postoperative complications in consultation group was significantly lower than that in control group (P < 0.05).
Conclusion The preoperative anesthesia consultation reduces the postoperative hospitalization time and early postoperative complications in elderly patients undergoing hip surgery. |
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