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新禁食禁饮管理方案对老年髋部骨折合并糖尿病患者髋关节置换术后的影响
白欣
天津市天津医院创伤髋关节一病区天津 300222
摘要:
目的 研究新禁食禁饮管理方案对老年髋部骨折合并糖尿病患者髋关节置换术后的影响。方法:选取2020年1月—2021年1月我院收治的192例择期实施髋关节置换术的老年糖尿病患者作为研究对象,按随机数字表法分为对照组和观察组,每组96例,对照组患者采用常规禁食禁饮方案(术前禁食12 h,禁饮4 h),观察组采用新型禁食禁饮管理方案(术前禁食6 h,禁饮2 h)。比较两组患者的手术相关指标,包括手术时间、出血量、输液量、住院时间、入住ICU病例数等,比较两组患者的血液和血糖指标,以及围手术期间不良反应发生率。结果:与对照组相比,观察组患者出血量更小,输液量更少,入住ICU病例也更少,住院时间更短,差异有统计学意义(P <0.05);观察组患者的血红蛋白水平高于对照组,血糖水平低于对照组(P<0.05);观察组的低血糖发生率低于对照组(6.25% vs 16.67%),差异有统计学意义;观察组各项不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:对实施髋关节置换术的老年髋部骨折合并糖尿病患者采用术前禁食6 h,禁饮2 h的管理策略有利于患者提高手术效果,维持血糖水平,改善围手术期的血流动力学状态,降低术后不良反应发生率,具有重要的临床应用价值。
关键词:  髋部骨折  禁食禁饮策略  髋关节功能  髋关节置换术  围手术期管理
DOI:10.3969/j.issn.1007-6948.2023.02.007
基金项目:天津市天津医院科技基金(Tjyy2112)
Effect of new fasting and abstinence management program after hip replacement in elderly patients with hip fracture complicated with diabetes
BAI Xin
The First Ward of Traumatic Hip Joint, Tianjin Hospital, Tianjin 300222, China
Abstract:
Objective To study the effects of new fasting and abstinence on hip replacement in elderly patients with hip fracture complicated with diabetes. Methods 192 elderly patients who were admitted to our hospital for elective hip replacement from January 2020 to January 2021 were selected as the research objects, and were divided into control group and observation group according to the random number table method, 96 cases in each group. The control group adopted the traditional fasting and abstaining regimen, and the observation group adopted the new fasting and abstaining regimen. Surgical results of patients in the two groups were recorded, including surgical indicators such as operative time, blood loss, infusion volume, length of hospital stay, and number of ICU cases. Blood and blood glucose indexes of patients in the two groups were evaluated, and incidence of adverse reactions during perioperative period was recorded. Results Compared with the control group after intervention, the observation group had less blood loss, less transfusion volume, fewer CASES of ICU admission and shorter hospital stay (P<0.05). Observation group had higher hemoglobin level, the differences were statistically significant (P<0.05). The incidence of hypoglycemia in observation group was significantly lower than that in control group (6.25% vs 16.67%). The adverse reactions in the observation group were significantly lower than those in the control group, with statistical significance (P<0.05). Conclusion Erythrocyte electrophoresis time for hip replacement of elderly hip fracture patients with diabetes mellitus, the preoperative fasting 6 h, forbidden to drink 2 h management strategy is helpful to improve the effect of surgery patients, maintaining blood sugar levels, improve perioperative hemodynamic state, reduce the incidence of postoperative adverse reactions, has the important clinical value.
Key words:  Hip fracture  abstinence and fasting strategies  hip function  hip replacement  perioperative management

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