经皮辅助关节囊入路全髋关节置换术的围术期康复护理  

Perioperative rehabilitation nursing in supercapsular percutaneously assisted total hip arthroplasty

作　　者：潘利智 柳亚男[1] 顾伟景 季英[1] 

机构地区：[1]复旦大学附属上海市浦东医院骨科,上海201399

出　　处：《中华创伤杂志》2017年第1期88-92,共5页Chinese Journal of Trauma

基　　金：上海市卫生和计划生育委员会科研课题（201440057）

摘　　要：目的探讨经皮辅助关节囊入路全髋关节置换术（SuperPATH）治疗老年股骨颈骨折患者围术期的康复护理效果。方法采用回顾性队列研究分析2016年1月-2016年7月进行SuperPATH治疗的老年股骨颈骨折患者30例，其中男7例，女23例；年龄75—91岁，平均77岁。术前运用多元化宣教，术后运用体位管理、心理支持联合超前镇痛及睡眠管理多维度强化护理及脱位护理并进行康复训练。根据焦虑自评量表（SAS）、睡眠状况自评量表（SRSS）、Barthel指数评定量表、髋关节Harris评分对患者治疗前后的临床表现进行比较。结果术前1dSAS评分为42．5～66．3分[（50．0±6．2）分]，术后第5天为33．8—53．8分[（41．5±5．2）分]（P〈0．05）；术前1dSRSS评分为24～37分[（29．9±3．1）分]，术后第5天为14～34分[（23．2±5．3）分]（P〈0．05）；术前1dBarthel评分为20—40分[（38．5±4．4）分]，术后第2天为35—55分[（49．7±6．3）分]，术后第5天为55—70分[（63．5±5．1）]分（P〈0．05）；术前1dHarris评分为4—25分[（14．8±4．2）分]，术后2d为59—75分[（67．3±5．1）分]，术后2周为66～85分[（79．2±4．3）分]（P〈0．05）。30例患者切口Ⅰ期愈合，均无并发症发生。结论针对性配合微创SuperPATH围术期康复护理，能有效缓解患者焦虑，改善患者睡眠状态，提高患者自理能力，提升患者术后康复效果并减少住院并发症的风险。Objective To investigate the effect of rehabilitation nursing in perioperative period of elderly patients with femoral neck fractures undergone supercapsular percutaneously assisted total hip （SuperPATH） arthroplasty. Methods A retrospective cohort analysis was made on 30 patients treated by total hip arthroplasty through the SuperPATH approach from January 2016 to July 2016. There were seven males and 23 females, aged 75-91 years （mean, 77 years）. Nursing methods contained application of pluralistic education before operation, application of body position management, psychologic support joint pain and sleep multidimensional strengthening nursing intervention and dislocation nursing after operation, and recovery training. Self-rating anxiety scale （ SAS）, self- rating scale of sleep （ SRSS）, Barthel index and Harris hip score were used to compare clinical manifestations before and after treatment. Results SAS score was 42.5-66.3 points [ （50.0 ±6.2） points ] one day before operation, compared to 33.8-53.8 points [ （41.5 ±5.2） points ] five day after operation （ P 〈 0.05 ）. SRSS score was 24-37 points [ （29.9 ±3.1 ） points ] one day before operation, compared to 14-34 points [ （ 23.2 ±5.3 ） points ] five day after operation （ P 〈 0. 05 ）. Barthel index was 20-40 points [ （38.5 ±4.4 ） points ] one day before operation, was 35-55 points [ （49.7 ＋ 6.3 ） points ] two day after operation and was 55- 70 points [ （63.5 ±5.1 ） ] points five day after operation, showing significant differences （ P 〈 0. 05 ）. Harris hip score was 4-25 points [ （14.8 ±4.2）points] one day after operation, was 59-75 points[ （67.3 ±5.1 ） points ] two day after operation and was 66-85 points [ （79.2 ±4. 3 ） points ] two weeks after operation, showing significant differences （ P 〈 0. 05 ）. All incision healed primarily. No complications occurred. Conclusion Perioperative rehabilitation nursing of minimally invasive SuperPATH arthroplasty is effective in all

关 键 词：股骨颈骨折 关节形成术 置换 髋 康复护理 

分 类 号：R473.6[医药卫生—护理学]