无痛管理临床路径在老年股骨骨折患者围术期护理中的应用  

Application of painless management based on clinical pathway in elderly patients with femoral fractures

作　　者：李溪晶[1] 陈雪[2] 史媛媛[3] 张贺丽[4] 

机构地区：[1]吉林大学第二医院急救医学科,长春130041 [2]吉林大学第二医院骨科,长春130041 [3]吉林大学第二医院护理部,长春130041 [4]吉林大学第二医院团委办公室,长春130041

出　　处：《中华现代护理杂志》2016年第26期3807-3810,共4页Chinese Journal of Modern Nursing

摘　　要：目的：探讨以临床路径为指导的无痛管理对老年股骨骨折患者围术期疼痛及术后康复的影响。方法选取2014年2月—2015年12月在吉林大学第二医院行手术治疗的老年股骨骨折患者112例,采用随机数表法分为观察组和对照组,每组各56例。观察组采用临床路径指导下的无痛管理模式进行护理,对照组采用常规护理。比较两组患者围术期疼痛情况、术后恢复情况和患者对护理的满意度。结果经重复测量方差分析发现,观察组术后各时间点VAS评分均低于对照组,两组VAS评分随时间延长而降低；观察组术后各时间点髋关节功能评分均高于对照组,两组髋关节功能评分随时间延长而升高,差异均有统计学意义（ P〈0.01）。观察组患者出院时满意度为92.86％,对照组为78.57％,观察组护理满意度高于对照组,差异有统计学意义（χ2＝4.667,P＝0.031）。结论以临床路径为指导的无痛管理可减轻老年股骨骨折患者围术期疼痛,促进患者术后康复,提高患者满意度,值得临床推广。Objective To explore the influences of painless management based on clinical pathway on pain during perioperative period, postoperative rehabilitation and the nursing satisfaction in elderly patients with femoral fractures.Methods A total of 112 elderly patients with femoral fractures who underwent surgeries in the Second Hospital of Jilin University were recruited from February 2014 to December 2015. They were divided into observation group （56 cases, nursing care with the painless management mode based on clinical pathway） and control group （ 56 cases, routine nursing care） according to the method of random number table. We compared the situation of pain during perioperative period, postoperative rehabilitation and the nursing satisfaction of patients between two groups.Results The results of analysis of variance for repeated measurement revealed that the scores of visual analogue scale （ VAS） of each postoperative time point in observation group were lower than those in control group, scores of VAS between two groups decreased with time increasing, the scores of hip joint function of each postoperative time point in observation group were higher than those in control group, scores of hip joint function between two groups increased with time increasing with significant differences （ P〈0.01） . The satisfaction with nursing care of patients in observation group （ 92. 86%） was higher than that in control group （78.57%） at discharge with a significant difference （χ2 =4. 667, P=0. 031）. Conclusions The painless management based on clinical pathway can relieve the pain of during perioperative period in elderly patients with femoral fractures, promote the postoperative rehabilitation and improve patients′ satisfaction. It is worthy of popularization in clinical work.

关 键 词：临床路径 老年患者 围术期 无痛管理 股骨骨折 

分 类 号：R473.6[医药卫生—护理学]