基于加速康复外科理念的早期冷敷在踝关节周围骨折患者护理中的应用  

Application of early cold compress after ankle peripheral fracture based on fast track surgery

作　　者：樊珊[1] 林华[2] 胡靖[3] 赵璟 孟阳[2] 侯悦[2] 李欢[2] 董阿姣 Fan Shan;Lin Hua;Hu ring;Zhao ring;Meng Yang;Hou Yue;Li Huan;Dong Afiao(Operating Room, Xi＇an Honghui Hospital, the Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710054, China;Ward of Trauma Lower Limbs, Xi＇an Honghui Hospital, the Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710054, Chin;Nursing Department, Xi＇an Honghui Hospital, the Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710054, Chin)

机构地区：[1]西安交通大学附属红会医院手术室,西安710054 [2]西安交通大学附属红会医院创伤下肢病区,西安710054 [3]西安交通大学附属红会医院护理部,西安710054

出　　处：《中华现代护理杂志》2018年第18期2182-2185,共4页Chinese Journal of Modern Nursing

基　　金：陕西省社会发展科技攻关项目（2015SF116;2015SF110;2016SF340）

摘　　要：目的探讨伤后及术后早期冷敷对踝关节周同骨折患者加速康复的作用。方法选择西安交通大学附属红会医院2015年1月-2016年1月踝关节周围骨折择期手术患者152例，随机分为对照组和观察组，每组76例。观察组伤后及术后24h对踝关节周围进行持续冰块冷敷及常规骨科处理，对照组给予常规骨科处理。比较两组患者患肢伤后及术后肿胀程度、面部表情分级疼痛评分（FRS）、住院天数、张力性水疱发生率及美国足踝外科协会（AOFAS）踝-后足评分。结果观察组患者手术前1d患肢肢体周径增加值为（17．1±5．7）mm、术后第3天为（14．1±5．9）mm，均低于对照组“值分别为8．566、5．065；P〈O．01）。术后第1天观察组FRS评分（2．8±0．9）分，对照组（3．3±1．1）分，两组疼痛评分比较差异有统计学意义（t=3．067，P〈0．01）。观察组发生张力性水疱病3例，对照组发生13例，差异有统计学意义（x^2=6．985，P〈0．01）。观察组住院天数（6．8±1．3）d，对照组为（8．9±2．6）d，差异有统计学意义（t=6．298，P〈0．01）。术后3个月观察组AOFAS踝-后足功能评分（80．5±15．1）分，对照组（74．2±11．8）分，差异有统计学意义（t=2．866，P〈0．01）。结论踝关节周围骨折伤后及术后早期冷敷具有减少骨折及手术创伤并发症，缩短平均住院时间，加快术后康复等优点，是加速康复外科理念在创伤骨科护理中实际应用的体现。Objective To explore the effects of early cold compress post injury and operation for patients with ankle peripheral fracture. Methods From January 2015 to January 2016, we selected 152 selective operation patients with ankle peripheral fracture from Xi＇an Honghui Hospital, the Affiliated Hospital of Xi＇an Jiaotong University. All of the patients were randomly divided into control group and observation group, 76 cases in each group. Patients of observation group accepted continuous cold compress around ankle and routine orthopaedics treatment post injury and 24 hours after operation. Patients of control group were treated with routine orthopaedics treatment. We compared the degree of swelling, Face Rating Scale （FRS）, hospital days, incidence of tension blister and the score of ankle hindfoot scale of American Orthopaedic Foot ＆ Ankle Society （AOFAS） of patients between two groups after injury and operation. Results The added value of limb circumference of patients of observation group one day before surgery and the third day after surgery was （17.1±5.7） mm and （14.1± 5.9） mm respectively lower than those of control group （t=8.566, 5.065 ; P 〈 0.01）. The score of FRS the first after surgery was （2.8± 0.9） in observation group and （3.3 ± 1.1） in control group with a significant difference （t=3.067, P 〈 0.01）. There were three patients with tension blister in observation group and 13 patients in control group with a significant difference （X^2-6.985, P〈 0.01）. The difference in hospital days between observation group [ （6.8 ± 1.3） days ] and control group [ （8.9 ±2.6） days ] was significant （t=6.298, P 〈 0.01）. There was a significant difference in the score of ankle hindfoot scale of AOFAS three months after surgery between observation group （80.5 ± 15.1） and control group （74.2 ± 11.8）（t=2.866, P 〈 0.01）. Conclusions The early cold compress post ankle peripheral fracture and operation has advantages in reducing fracture and surger

关 键 词：骨折 冷敷 踝关节 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]