探讨加速康复外科理念下，围术期多模式镇痛在老年股骨转子间骨折治疗中的应用。

回顾性分析2016年6月至2017年6月南昌大学第一附属医院骨科采用PFNA手术治疗的45例老年（≥80岁）股骨转子间骨折患者，其中男性19例（42.2%），女性26例（57.8%），平均年龄为（81.3±1.0）岁。所有患者均在骨折后48 h内采取闭合复位PFNA内固定手术，并采取多模式镇痛方案进行干预，采用简式McGill疼痛问卷和Harris髋关节功能评分标准来观察患者疼痛缓解、髋关节功能恢复的情况。

所有患者均获得满意随访，随访率100%，随访时间为3~14个月，平均（9.0±2.0）个月。末次随访时，简式McGill疼痛问卷结果：无痛39例，轻度6例，中度0例，重度0例，无痛率约达86.67%；Harris髋关节功能评分结果：优25例，良13例，可7例，差0例，优良率约达84.44%。

围术期多模式镇痛应用于老年股骨转子间骨折患者的治疗中，有利于减少因骨折后疼痛带来的一系列负面影响，加快术后康复进程。

To explore the application of perioperative multimodal analgesia in the treatment of intertrochanteric fractures in the elderly under the guidance of the concept of accelerated rehabilitation surgery.

A retrospective study of 45 elderly (≥80 years old) femoral intertrochanteric fractures who underwent PFNA surgery in our department from June 2016 to June 2017.There were 19 males (42.2%) and 26 females (57.8%) with an average age of (81.3±1.0) years. All patients underwent closed reduction PFNA within 48 h after fracture. Internal fixation was performed and a multimodal analgesia protocol was used to intervene. The Jane McGill pain questionnaire and the Harris hip function score were used to observe pain relief and hip function recovery.

All patients were evaluated by the simple McGill Pain Questionnaire and the Harris Hip Function Score. Patients were followed up for 3-14 months with an average of (9.0±2.0) months. The final follow-up showed 39 cases of painless of the simple McGill pain questionnaire, 6 cases of mild pain, 0 case of moderate, 0 case of severe, the rate of painlessness was about 86.67%. Harris hip function score were excellent in 25 cases, 13 cases were good, 7 cases were fair, and 0 case were poor. The excellent and good rate was about 84.44%.

Perioperative multi-mode analgesia applied to the elderly patients with intertrochanteric fractures is beneficial to reduce the negative effects of traumatic stress caused by post-fracture pain and accelerate the postoperative recovery process.