老年髋部骨折患者术后日常生活活动能力的影响因素分析  

Influencing factors of postoperative activities of daily living in elderly patients after hip fracture

作　　者：淦细红[1] 朱菁菁[1] 蔡程芳 叶杨[1] 夏玉秀[1] 徐朗朗[1] 陈和珍[1] 王谊[1] 

机构地区：[1]温州医科大学附属第二医院骨科,温州325000

出　　处：《中华现代护理杂志》2017年第33期4259-4262,共4页Chinese Journal of Modern Nursing

基　　金：温州市科技局资助项目（Y20130200）

摘　　要：目的 探讨影响老年髋部骨折患者术后日常生活活动能力的危险因素.方法 采用便利抽样方法选取2013年10月—2015年6月住院的老年髋部骨折手术患者150例,最终收集资料141例,记录其性别、年龄、基础疾病、手术方式、术后并发症、下地时间、行走时有无辅助器具、家庭照顾者、复查情况,评估患者术后半年的日常生活活动能力.用t检验及χ2检验对以上因素进行单因素分析,采用Logistic回归分析对可能的危险因素进行分析.结果 单因素分析显示术后日常生活活动能力恢复受年龄、手术方式、术后并发症、下地时间、行走辅助器的影响（P〈0.05）;多因素Logistic回归分析显示,年龄（OR=1.065,95%CI：1.010~1.124,P=0.020）、手术方式（OR=2.900,95%CI：1.200~7.008,P=0.018）、术后并发症（OR=6.366,95%CI：2.592~15.632,P〈0.001）、下地时间（OR=2.684,95%CI：1.133~6.359,P=0.025）、行走辅助器（OR=5.796,95%CI：1.542~21.780,P=0.009）是影响老年髋部骨折患者术后日常生活活动能力的危险因素.结论 患者年龄越大、行切开内固定手术、术后发生并发症、下地时间超过3个月、行走时不使用辅助器具都会影响患者术后日常生活活动能力的恢复,从而影响患者生活质量,故护理人员应针对危险因素给予积极预防和干预.Objective To explore the risk factors of postoperative activities of daily living in elderly patients after hip fracture. Methods By convenience sampling,from October 2013 to June 2015,150 elderly patients having undergone surgery after hip fracture were selected,with data of 141 cases finally collected. Gender,age,underlying diseases,surgical procedures,postoperative complications,ambulation time,whether walking with aids,family caregivers and reexamination conditions were recorded for evaluation of the patients about their activities of daily living half a year after the surgery. Mean comparison and chi-square test were used for univariate analysis about the above factors and Logistic regression analysis was used to identify possible risk factors. Results It was shown in univariate analysis that recovery of postoperative activities of daily living was influenced by age,surgical procedures,postoperative complications,ambulation time,walking aids,etc. （P〈 0.05）;it was shown in multivariate logistic regression that age （OR=1.065,95%CI：1.010-1.124, P=0.020）,surgical procedures （OR=2.900,95%CI：1.200-7.008,P=0.018）,postoperative complications （OR=6.366,95%CI：2.592-15.632,P〈 0.001）,ambulation time （OR=2.684,95%CI：1.133-6.359,P=0.025） and walking aids （OR=5.796,95%CI：1.542-21.780,P=0.009） were risk factors of postoperative daily living ability in elderly patients after hip fracture. Conclusions Old age,developing internal fixation surgery after incision,postoperative complications, walking more than 3 months after operation or walking without aids affect postoperative activities of daily living in elderly patients after hip fracture,thus affecting their quality of life, which makes it necessary for nursing staff to focus on risk factors for positive prevention and intervention.

关 键 词：老年人 日常生活活动能力 外科手术 髋部骨折 影响因素 

分 类 号：R473.6[医药卫生—护理学]