探讨老年综合评估技术及整体整合医学理念应用于老年髋部骨折管理的有效性。

选取2024年4月1日至12月31日就诊于常州市金坛第一人民医院的84例老年髋部骨折患者，采用随机数字表法分为观察组和对照组，每组各42例。观察组采用基于老年综合评估技术及整体整合医学理念的管理模式进行治疗，对照组采用传统髋部骨折诊疗路径进行治疗。观察两组患者一般资料、术前等待时间、术后康复开始时间、住院时间、住院费用、并发症发生情况，以及术后4、8、12周的髋关节功能评分（Harris评分）及Barthel指数。计量资料的比较采用t检验，计数资料的比较采用χ²检验或Fisher确切概率法；组间不同时间点的比较采用重复测量方差分析。

观察组患者术前等待时间、住院时间、术后康复开始时间、住院费用明显优于对照组，差异均有统计学意义（t=-2.649、2.062、-2.352、-2.004，P<0.05）。住院期间，观察组肺炎、便秘、低蛋白血症的发生率明显低于对照组，差异均有统计学意义（χ²=4.141、4.043、3.967，P<0.05）；两组患者压疮、谵妄、深静脉血栓、切口感染发生率及围术期死亡率的差异均无统计学意义（P>0.05）。两组患者术后Harris评分与Barthel指数的组间效应和时间效应均有统计学意义（F=4.256、5.103，48.732、56.847；P<0.05或0.01），且各个时点的组间差异也有统计学意义（P<0.05）。

将老年综合评估技术及整体整合医学理念应用于老年髋部骨折的全流程管理，有利于促进老年髋部骨折患者术后早期康复、减少围术期并发症的发生以及术后髋关节功能及日常生活能力的恢复。

To explore the effectiveness of applying geriatric comprehensive assessment(CGA) techniques and holistic integrative medicine concepts to the management of geriatric hip fracture.

A total of 84 patients with geriatric hip fracture who visited Changzhou Jintan First People's Hospital from April 1 to December 31, 2024 were selected. They were randomly divided into the observation group and the control group using a random number table, with 42 cases in each group. The observation group was treated with a management model based on comprehensive geriatric assessment techniques and holistic integrative medicine concepts, while the control group received traditional hip fracture diagnosis and treatment. The general information, preoperative waiting time, postoperative rehabilitation start time, length of hospital stay, medical expenses, incidence of complications, as well as Harris hip scores and Barthel Index at 4, 8, and 12 weeks after the operation were compared between the two groups. T test was used to compare measurement data, chi-square test or Fisher's exact probability method was used to compare count data, and repeated measures analysis of variance was used to compare the Harris hip scores and Barthel Index between the two groups at different time points.

The preoperative waiting time, hospital stay, postoperative rehabilitation start time, and hospitalization cost of the patients in the observation group were significantly better than those in the control group, and the differences were statistically significant (t=-2.649, 2.062, -2.352, -2.004; P < 0.05). During the hospitalization period, the incidence rates of pneumonia, constipation and hypoproteinemia in the observation group were significantly lower than those in the control group, and the differences were statistically significant (χ² = 4.141, 4.043, 3.967; P < 0.05); and there were no statistically significant differences in the incidence rates of pressure ulcers, delirium, deep vein thrombosis, incision infection and perioperative mortality between the two groups (P > 0.05). The inter-group and time effects of the Harris score and Barthel index in the two groups of patients after surgery were statistically significant (F=4.256, 5.103, 48.732, 56.847; P < 0.05 or P < 0.01), and the differences between groups at each time point were also statistically significant (P < 0.05).

Applying the CGA technology and the holistic integrated medical concept to the entire process management of elderly hip fractures is conducive to promoting the early postoperative rehabilitation of elderly patients with hip fractures, reducing the occurrence of perioperative complications, and facilitating the recovery of hip joint function and daily living ability after surgery.