王永亮,任 荣

老年髋部骨折是老龄化社会中高发的骨科创伤，具有高死亡率、高致残率、高并发症发生率的特点，严重威胁老年人生命健康并加重社会医疗负担。随着人口老龄化加剧及医疗技术发展，老年髋部骨折的临床治疗理念与技术不断革新。本文系统综述老年髋部骨折的手术治疗、围手术期管理及康复治疗的最新研究进展，分析当前治疗中存在的挑战，展望未来发展方向。研究表明，早期手术干预、精准化治疗方案选择、加速康复外科理念的全面应用及多学科协作模式的推广，是改善老年髋部骨折患者预后的核心策略；微创技术、智能辅助手术、新型生物材料的应用为治疗优化提供了新路径。本文旨在为临床医师提供全面的治疗参考，推动老年髋部骨折治疗向更安全、高效、精准的方向发展。

老年髋部骨折；手术治疗；围手术期管理；康复治疗；ERAS

[1] Komiya D,Takeya H,Minakami K,et al.Association between gait performance at discharge and total anticholinergic burden in elderly patients after hip fracture surgery:A single-center retrospective cohort study[J].Archives of Gerontology and Geriatrics Plus,2025, 2(4):100223-100223. [2] 郑国庆,张瑛.评《骨科疾病康复护理》老年髋部骨折患者术后康复护理方案的构建与应用[J].临床误诊误治,2025,38(20):142. [3] 喇瑞,吴乾,张中泰,等.老年髋部骨折术后二次骨折发生危险因素分析[J].中国组织工程研究,2026,30(15):3920-3928. [4] 殷悦恒,田楚伟,周钧,等.老年髋部骨折预后的围术期相关危险因素研究进展[J].实用老年医学,2025,39(10):1062-1067. [5] Liu D Y,Ma Y J,Wang H J,et al.Effect of perioperative psychological intervention on recovery in elderly hip fracture patients with comorbid post-traumatic stress disorder.[J].World journal of psychiatry,2025,15(10):106705 [6] Mori Y,Tarasawa K,Tanaka H,et al.Increased Risk of Postoperative Complications in Elderly Hip Fracture Patients With Cognitive Impairment:Evidence From a Japanese Nationwide Database.[J].Geriatrics&gerontology international,2025, [7] Tang W,Li R.The correlation between smoking and preoperative deep venous thrombosis after hip fracture in geriatric patients:a propensity score-matched study.[J].Journal of orthopaedic surgery and research,2025,20(1):896. [8] Ceolin C,CannavòD,Sella S,et al.Hip Fracture Geriatric(HIP-G)Index:Predicting 12-Month Mortality in Older Adults With Hip Fracture. [J].Journal of the American Medical Directors Association,2025,105925. [9] 张梦丹,陈文彬,梁莹,等.早期吞咽摄食护理结合个体化营养干预在老年髋部骨折合并吞咽障碍患者中的应用[J].黑龙江医药科学,2025,48(10):45-47. [10] 张润银,朱燕玲.营养支持及个性化康复护理对老年髋部骨折患者术后康复效果的影响[J].生命科学仪器,2025,23(05):204-206. [11] Rosique V A,Tercero G E,Rosique V A,et al.Anticholinergic burden and postoperative mortality in older adults with hip fracture:a real-world observational study.[J].Archives of orthopaedic and trauma surgery,2025,145(1):474. [12] Chen J,Wen Y.Observation of the impact of the ERAS-based multidisciplinary treatment model(MDT)on the perioperative management of elderly patients with hip fractures in primary hospitals.[J].Injury,2025,56(12):112812. [13] 张筱娴,徐雅萍.老年髋部骨折患者衰弱影响因素的研究进展[J].中日友好医院学报,2025,39(05):315-317+320. [14] 袁柳松,陈俊刚,陈阳,等.老年髋部骨折患者术前营养状况对术后切口愈合的影响及预测模型构建[J/OL].实用临床医药杂志,1-7[2025-10-26]. [15] 刘佳欢,刘伟楠,邢冠男.评《老年髋部骨折》老年髋部骨折术后早期康复护理干预对患者肢体功能恢复及生活质量的影响[J].临床误诊误治,2025,38(19):141. [16] 郭丽雯,张瑛.评《实用骨科护理》早期康复训练联合疼痛精准护理对老年髋部骨折患者功能恢复的效果[J].临床误诊误治,2025,38(19):142. [17] 王伟,侯慧洁,李安超.腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉在老年髋部骨折患者手术中的效果对比[J].河南医学研究, 2025,34(19):3571-3575. [18] Zhong Q,Si B,Zhou L.Clinical effectiveness of intraoperative continuous pump infusion of remimazolam on postoperative delirium in elderly patients with hip fractures.[J].Experimental and therapeutic medicine,2025,30(6):225. [19] Munk T,Beck M A,Møller M C,et al.The effects of a dietitian-supported multidisciplinary nutrition intervention on optimizing nutrition care in older patients with hip fracture and at nutrition risk-A quality improvement study.[J].Nutrition in clinical practice:official publication of the American Society for Parenteral and Enteral Nutrition,2025, [20] 柴利娟,苗洁.骨折联盟服务(FLS)对老年股骨粗隆间骨折患者功能预后及生存率的影响[J].科学技术与工程,2025,25(28):11932-11937. [21] Watanabe Y,Sato Y,Tamura T,et al.Relationship Between Oral Frailty Index-8 Cutoff Values and Dysphagia in Older Patients With Hip Fracture:A Retrospective Cohort Study.[J].Journal of oral rehabilitation,2025, [22] Mehta R,Sah R.Comment on"The Effect of Postoperative Frailty on Morbidity and Mortality in Geriatric Hip Fracture Patients: Prospective Cohort Study".[J].Journal of perianesthesia nursing:official journal of the American Society of PeriAnesthesia Nurses,2025, [23] Thompson Z,M.L S,B.C J K,et al.Factors Associated With Time to Surgery of Geriatric Hip Fractures:An Analysis of the American College of Surgeons'Trauma Quality-Improvement Program Database[J].Journal of the American Academy of Orthopaedic Surgeons,2025, [24] Wang J,Zhang X.Five Cases of Hip Fracture in Elderly Patients Complicated by New Silent Cerebral Infarction:Clinical Alert and Analysis.[J].Journal of the College of Physicians and Surgeons--Pakistan:JCPSP,2025,35(10):1357-1358. [25] Liu W,Hao H.The critical role of nutritional care in managing hip fractures in the elderly[J].Asian Journal of Surgery,2025, 48(10):6197-6198. [26] Zhuo Z,Hong W,Ma G.Effect of timing of surgery on postoperative complications and prognosis in elderly patients with hip fractures[J].Frontiers in Medicine,2025,12 1646938-1646938. [27] Baki H,Aydın FÖ.C-reactive protein-albumin-lymphocyte(CALLY)index as a predictor of early mortality in elderly patients with hip fractures.[J].Ulusal travma ve acil cerrahi dergisi=Turkish journal of trauma&emergency surgery:TJTES,2025,31(10):1011-1017. [28] Çiğdem Kaya,Özlem Bilik,Yılmaz Kaya,等.Factors associated with frailty and the effect of frailty on postoperative outcomes in older adults with hip fracture.[J].Ulusal travma ve acil cerrahi dergisi=Turkish journal of trauma&emergency surgery:TJTES,2025,31(10):1055-1064. [29] Li B,Chang J,Wang Y,et al.Geriatric cognitive frailty and short-term prognosis following hip fracture surgery[J].BMC Geriatrics,2025, 25(1):734-734. [30] Møller C,Pudselykke F,Knudsen A,et al.The beneficial effects of a multidisciplinary nutritional intervention on nutritional care in older patients with hip fracture and at nutrition risk[J].Clinical Nutrition ESPEN,2025,69 1138-1138.

点击下载PDF