Abstract: Objective To investigate the application effect of the integrated traditional Chinese and Western medicine-enhanced recovery after surgery （ERAS） model in the perioperative period of Percutaneous Vertebroplasty （PVP） for elderly patients with osteoporotic vertebral fracture （OVF）. Methods A retrospective analysis was conducted on 50 elderly OVCF patients who underwent PVP at Qingyuan Hospital of Traditional Chinese Medicine, affiliated with Guangzhou University of Chinese Medicine from September 2021 to March 2022. These patients were designated as the control group and received interventions according to the conventional disease management pathway. Another 50 patients with OVF who underwent the same surgery from April 2022 to September 2022 were assigned to the observation group and received a health management intervention integrating traditional Chinese and Western medicine characteristics. Perioperative indicators such as operation time, bone cement volume, length of hospital stay, hospital costs, and complication rates were collected. Data from assessment scales, including the Patient Health Questionnaire-9 （PHQ-9）, Visual Analogue Scale （VAS）, Oswestry Disability Index （ODI）, and EuroQol-5 Dimensions （EQ-5D）, were collected preoperatively, on postoperative day 1, and at 6 months postoperatively. Vertebral body recovery was assessed by measuring the anterior vertebral height （AVH） and local kyphosis angle （LKA） of the injured vertebra. Results The time to ambulation and hospital stay length in the observation group were significantly shorter than those in the control group （P< 0.05）. Hospitalization costs were also significantly lower in the observation group compared to the control group （P< 0.05）. There were no significant differences in anesthesia time, bone cement volume, or operation time between the two groups （P> 0.05）. The pain level in the observation group was slightly lower than that in the control group on postoperative day 1, with a statistically significant difference in VAS score （P< 0.05）. There were no significant differences in ODI, AVH, or LKA between the two groups at preoperative, postoperative day 1, 3 months, and 6 months compared to preoperative values （P> 0.05）. The incidence of postoperative constipation in the observation group was lower than that in the control group （P< 0.05）, while no significant differences were found in other complications （P> 0.05）. In the quality-of-life scale, the dimensions of pain/discomfort and anxiety/depression had significantly better outcomes in the observation group compared to the control group （P< 0.05）. Conclusion The integrated traditional Chinese and Western medicine ERAS model is a reliable and effective perioperative management strategy. It helps in early pain relief, alleviates postoperative anxiety and depression, promotes rehabilitation after PVP, and improves patients' postoperative quality of life.

Key words: elderlyosteoporotic vertebral compression fracture, percutaneous vertebroplasty, integrated traditional Chinese and Western medicine, enhanced recovery after surgery

摘要： 目的 探讨中西医结合加速康复外科（ERAS）模式在高龄骨质疏松性椎体骨折（OVF）患者经皮椎体成形术（PVP）围手术期的应用效果。方法 回顾性选取2021年9月至2022年3月于广州中医药大学附属清远市中医院接受经皮椎体成形术（PVP）治疗的高龄骨质疏松性椎体压缩性骨折（OVCF）患者50例,设为对照组,采用常规疾病管理路径模式进行干预。选取2022年4月至2022年9月接受相同手术治疗的OVF患者50例,设为观察组,运用中西医特色健康管理模式干预。收集两组患者围手术期相关指标如手术时间、骨水泥灌注量、住院天数、住院费用及并发症发生情况;术前、术后1 d、术后6个月,通过评分调查项目,收集患者健康问卷-9（PHQ-9）、视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、欧洲五维健康量表（EQ-5D）数据以及通过测量损伤椎体的椎体前缘高度（AVH）和局部后凸角（LKA）了解椎体恢复情况。结果 观察组患者在术后下床活动时间、住院天数较对照组减少（P<0.001）;住院费用方面,观察组较对照组有所下降,与对照组比较,差异有统计学意义（P<0.05）。两组麻醉时间、骨水泥用量、手术时间差异无统计学意义（P>0.05）。观察组在术后第1 d疼痛程度要低于对照组（P<0.05）。两组间在术前、术后1 d、术后3个月及术后6个月ODI、AVH、LKA与术前比较,差异均无统计学意义（P>0.05）。观察组术后便秘率低于对照组（P<0.05）,其余指标差异无统计学意义（P>0.05）。两组生活质量量表中,观察组在多个维度的评分优于对照组。结论 中西医结合ERAS是一种可靠、有效的围手术期管理方法,有助于早期缓解疼痛,改善患者术后焦虑、抑郁情绪,促进PVP后期康复,改善患者术后生活质量。

关键词: 高龄, 骨质疏松性椎体压缩骨折, 经皮椎体成形术, 中西医结合健康管理模式, 加速康复外科