关键词: 老年, 髋关节骨折, 围术期预后, 外周神经阻滞

Abstract: Objective To retrospectively analyze the perioperative data of patients aged over 65 years undergoing surgery for hip fracture in Peking Union Medical College Hospital in the past 5 years. Methods: The patients aged over 65 years undergoing surgery for unilateral hip fracture between July 2009 and June 2014 were included in this study, with an average age of 78.8±7.2 years. According to different anesthetic techniques, all cases were divided into three groups: general anesthesia (121 cases), intervertebral anesthesia (215 cases), and nerve block group (127 cases). The data about preoperative complications and the course of operation were collected, the intraoperative hemodynamic changes, postoperative ICU stay, total hospital stay, mortality, morbidity and the cost of treatment were compared. Results: Compared with general and intervertebral groups, patients in nerve block group were older, more patients were in ASA III grade, more patients were complicated with coronary heart disease, COPD, lung infection or respiratory failure preoperatively (P<0.05), at the same time, the intraoperative maximum variations of blood pressure and heart rate significantly decreased in nerve block group compared with other two groups (P<0.05). Compared with the general group, patients in the regional groups (intervertebral and nerve block) had shorter postoperative ICU stay (P<0.05) and lower total costs of treatment (P<0.01). Conclusion: Peripheral nerve block is a safe and effective anesthetic technique for patients undergoing hip fracture surgery, especially for those who were older, in ASA III grade and complicated with coronary heart disease or diseases in respiratory system. This technique could make the intraoperative hemodynamics stable and cut down the postoperative ICU stay and the costs of treatment.

Key words: elder patient, hip fracture, perioperative prognosis, nerve block