[1]宋云飞,刘佳鑫,张占磊,等.加速康复外科联合电针与癫狂梦醒汤治疗老年髋部骨折围手术期谵妄的临床研究[J].医学信息,2025,38(24):54-59.[doi:10.3969/j.issn.1006-1959.2025.24.010]
　SONG Yunfei,LIU Jiaxin,ZHANG Zhanlei,et al.Clinical Study of Enhanced Recovery After Surgery Combined with Electro Acupunctureand Diankuang Mengxing Decoction in the Treatment of Perioperative Deliriumin Elderly Patients with Hip Fracture[J].Journal of Medical Information,2025,38(24):54-59.[doi:10.3969/j.issn.1006-1959.2025.24.010]
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加速康复外科联合电针与癫狂梦醒汤治疗老年髋部骨折围手术期谵妄的临床研究()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年24期
页码:
54-59
栏目:
论著
出版日期:
2025-12-15

文章信息/Info

Title:
Clinical Study of Enhanced Recovery After Surgery Combined with Electro Acupunctureand Diankuang Mengxing Decoction in the Treatment of Perioperative Deliriumin Elderly Patients with Hip Fracture
文章编号:
1006-1959（2025）24-0054-06
作者:
宋云飞; 刘佳鑫; 张占磊; 毕梦娜
四川省骨科医院髋膝关节病科，四川 成都 610000
Author(s):
SONG Yunfei;  LIU Jiaxin;  ZHANG Zhanlei;  BI Mengna
Department of Hip and Knee Joint Diseases, Sichuan Orthopedic Hospital, Chengdu 610000, Sichuan, China
关键词:
老年髋部骨折; 加速康复外科; 围手术期谵妄; 电针; 癫狂梦醒汤; 血清S100B蛋白
Keywords:
Hip fracture in the elderly;  Enhanced recovery after surgery;  Perioperative delirium;  Electro acupuncture;  Diankuang Mengxing decoction;  Serum S100B protein
分类号:
R687.3；R473.6
DOI:
10.3969/j.issn.1006-1959.2025.24.010
文献标志码:
A
摘要:
目的 评价加速康复外科（ERAS）理念联合中西医结合方案对老年髋部骨折围手术期谵妄的干预效果，阐明其作用机制。方法 采用随机对照研究设计，纳入2023年1月-2024年12月四川省骨科医院收治的100例老年髋部骨折手术期谵妄患者，按1∶1随机分为试验组（n=50）和对照组（n=50）。对照组采用ERAS常规管理+奥氮平治疗，试验组采用ERAS+电针（神门、内关、百会、印堂）+癫狂梦醒汤加减治疗。比较两组谵妄发生率、严重程度及相关生化指标，采用重复测量方差分析评估时间效应与组间效应。结果 试验组谵妄持续时间、术后住院时间、下床活动时间均短于对照组（P＜0.05）；治疗后第3、7天，试验组谵妄分级量表（DRS）、简明精神病量表（BPRS）、临床总体疗效量表（CGI-SI）评分均低于对照组（P＜0.05），血清IL-6、TNF-α及S100B蛋白水平降低（P＜0.05）；试验组总有效率（88.00%）高于对照组（66.00%）（P＜0.05）；两组不良反应发生率无统计学差异（P＞0.05）。结论 ERAS联合中西医结合方案可通过调节神经炎症反应降低谵妄风险，改善临床预后，安全性良好。
Abstract:
Objective To evaluate the intervention effect of enhanced recovery after surgery (ERAS) concept combined with integrated traditional Chinese and Western medicine on perioperative delirium in elderly patients with hip fracture, and to clarify its mechanism. Methods A randomized controlled study design was used to include 100 elderly patients with delirium during hip fracture surgery admitted to Sichuan Orthopaedic Hospital from January 2023 to December 2024. They were randomly divided into experimental group (n=50) and control group (n=50) according to 1∶1. The control group was treated with ERAS routine management+olanzapine, and the experimental group was treated with ERAS+electro acupuncture (Shenmen, Neiguan, Baihui, Yintang)+modified Diankuang Mengxing decoction. The incidence, severity and related biochemical indexes of delirium were compared between the two groups. Repeated measures analysis of variance was used to evaluate the time effect and inter-group effect. Results The duration of delirium, postoperative hospitalization stay and ambulation time in the experimental group were significantly shorter than those in the control group (P<0.05). On the 3rd and 7th day after treatment, the scores of Delirium Rating Scale (DRS), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity (CGI-SI) in the experimental group were lower than those in the control group (P<0.05), and the levels of serum IL-6, TNF-α and S100B protein were decreased (P<0.05). The total effective rate of the experimental group (88.00%) was higher than that of the control group (66.00%) (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion ERAS combined with integrated traditional Chinese and Western medicine can reduce the risk of delirium by regulating neuroinflammatory response and improve clinical prognosis, with good safety.

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更新日期/Last Update: 1900-01-01