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ENGLISH ABSTRACT
老年髋部骨折围术期护理临床实践专家共识（2023版）
宋咪
孔丹
高远
陈亚萍
陈小华
崔怡
丁俊琴
冯乐玲
冯丽丽
郭锦丽
韩云
胡靖
胡三莲
黄天雯
贾宇
金艳
孔祥燕
李海燕
李辉
李伦兰
李水霞
林华
刘娟
鲁雪梅
宁宁
彭伶丽
史凌云
万昌丽
王洁
王琦
王谊
许蕊凤
应瑛
张萍
张世君
周文娟
中华护理学会骨科护理专业委员会
作者及单位信息
·
DOI： 10.3760/cma.j.cn501098-20221109-00744
Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture (version 2023)
Song Mi
Kong Dan
Gao Yuan
Chen Yaping
Chen Xiaohua
Cui Yi
Ding Junqin
Feng Leling
Feng Lili
Guo Jinli
Han Yun
Hu Jing
Hu Sanlian
Huang Tianwen
Jia Yu
Jin Yan
Kong Xiangyan
Li Haiyan
Li Hui
Li Lunlan
Li Shuixia
Lin Hua
Liu Juan
Lu Xuemei
Ning Ning
Peng Lingli
Shi Lingyun
Wan Changli
Wang Jie
Wang Qi
Wang Yi
Xu Ruifeng
Ying Ying
Zhang Ping
Zhang Shijun
Zhou Wenjuan
Orthopedic Nursing Committee of Chinese Nursing Association
Authors Info & Affiliations
Song Mi
Chinese PLA General Hospital, Beijing 100853, China
Kong Dan
Chinese PLA General Hospital, Beijing 100853, China
Gao Yuan
Chinese PLA General Hospital, Beijing 100853, China
Chen Yaping
Peking Union Medical College Hospital, Beijing 100730, China
Chen Xiaohua
Chongqing General Hospital, Chongqing 401147, China
Cui Yi
Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
Ding Junqin
Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
Feng Leling
Ningbo No.6 Hospital, Ningbo 315042, China
Feng Lili
Aerospace Center Hospital, Beijing 100049, China
Guo Jinli
Second Hospital of Shanxi Medical University, Taiyuan 030001, China
Han Yun
Shenzhen Second People′s Hospital, Shenzhen 518035, China
Hu Jing
Honghui Hospital of Xi′an Jiaotong University, Xi′an 710054, China
Hu Sanlian
Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
Huang Tianwen
First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510062, China
Jia Yu
Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Jin Yan
Yan′an Hospital Affiliated to Kunming Medical University, Kunming 650051, China
Kong Xiangyan
Peking University People′s Hospital, Beijing 100044, China
Li Haiyan
Affiliated Hospital of Qingdao University, Qingdao 266000, China
Li Hui
Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Li Lunlan
First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
Li Shuixia
Honghui Hospital of Xi′an Jiaotong University, Xi′an 710054, China
Lin Hua
Honghui Hospital of Xi′an Jiaotong University, Xi′an 710054, China
Liu Juan
General Hospital of Southern Theater Command, Guangzhou 510010, China
Lu Xuemei
Beijing Jishuitan Hospital, Beijing 100035, China
Ning Ning
West China Hospital of Sichuan University, Chengdu 610041, China
Peng Lingli
Xiangya Hospital, Central South University, Changsha 410008, China
Shi Lingyun
First Affiliated Hospital of Xinjiang Medical University, Urumchi 830011, China
Wan Changli
Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
Wang Jie
Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215127, China
Wang Qi
First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
Wang Yi
Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
Xu Ruifeng
Peking University Third Hospital, Beijing 100081 China
Ying Ying
Ningbo No.6 Hospital, Ningbo 315042, China
Zhang Ping
Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
Zhang Shijun
Qilu Hospital of Shandong University, Jinan 250012, China
Zhou Wenjuan
Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China
Orthopedic Nursing Committee of Chinese Nursing Association
·
DOI： 10.3760/cma.j.cn501098-20221109-00744
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摘要

髋部骨折是老年人最严重的骨质疏松性骨折，具有高致残率和致死率。手术技术的提高和多学科协作管理模式对改善患者预后具有重要作用，也对围术期护理提出了更高要求。患者整体功能衰退、器官合并症增多、麻醉及手术对机体储备的二次打击使护理难度增加，且我国尚缺乏对于老年髋部骨折患者围术期护理的规范来指导临床实践。因此，中华护理学会骨科护理专业委员会组织相关专家，基于循证医学方法，制订《老年髋部骨折围术期护理临床实践专家共识（2023版）》，围绕老年髋部骨折围术期健康教育、病情监测与观察、并发症风险评估与预防、康复训练等方面提出11条推荐意见，以指导临床实践，提升围术期护理质量，改善老年髋部骨折患者预后。

髋骨折;老年人;围手术期护理;专家共识
ABSTRACT

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Hip fractures;Aged;Perioperative nursing;Consensus
Gao Yuan, Email: mocdef.3ab61dznauyoag, Tel: 0086-1381-0548-731

IPGRP-2022CN679

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引用本文

宋咪,孔丹,高远,等. 老年髋部骨折围术期护理临床实践专家共识（2023版）[J]. 中华创伤杂志,2023,39(03)：214-222.

DOI:10.3760/cma.j.cn501098-20221109-00744

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未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

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髋部骨折是老年人最严重的骨质疏松性骨折，致残率高达50%，术后1年致死率可达28%~36% ［ 1 , 2 ］ 。随着我国人口老龄化加剧，老年髋部骨折患者的绝对数量将激增。预计到2050年，我国每年将新增130万例老年髋部骨折患者，给家庭及社会带来沉重的经济负担 ［ 3 , 4 ］ 。手术治疗及多学科协作管理可减少骨折断端出血、缓解疼痛，尽早恢复运动功能，缩短住院时间、减少医疗费用，已成为老年髋部骨折公认的最主要治疗方法及管理模式 ［ 5 , 6 ］ ，但由于高龄、衰弱、合并症等因素，老年髋部骨折患者围术期发生不良事件的风险显著增加 ［ 7 , 8 ］ 。因此，加强围术期综合管理、降低围术期风险是临床关注的重点问题。护理作为老年髋部骨折围术期综合管理的重要组成部分，对预防并发症、促进早期康复、改善远期预后具有重要作用 ［ 9 ］ 。但年龄所致的身体机能下降、疾病所致的功能损伤、麻醉及手术对机体储备的二次打击使老年髋部骨折患者的护理难度增加，且现有指南或共识多关注手术、麻醉及抗骨质疏松治疗等问题 ［ 10 , 11 , 12 ］ ，对护理问题的关注较少，同时国内缺乏标准化的围术期护理临床实践规范。因此，中华护理学会骨科护理专业委员会组织相关领域专家，基于循证医学方法，围绕老年髋部骨折患者的健康教育、病情监测与观察、并发症风险评估与预防、康复训练等重点内容制订《老年髋部骨折围术期护理临床实践专家共识（2023版）》（下称“本共识”），旨在规范我国老年髋部骨折围术期护理。
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备注信息
A
高远，Email： mocdef.3ab61dznauyoag，电话：13810548731
B

宋咪、孔丹：文献检索、共识撰写；高远：共识选题及设计；其他作者：参与共识讨论及修改

C

IPGRP-2022CN679

D
宋咪, 孔丹, 高远, 等. 老年髋部骨折围术期护理临床实践专家共识（2023版）[J]. 中华创伤杂志, 2023, 39(3): 214-222. DOI: 10.3760/cma.j.cn501098-20221109-00744.
E
所有作者声明不存在利益冲突
F
国家自然科学基金 (72204262)
国家重点研发计划 (2022YFC2504300)
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