基于加速康复外科的早期离床干预在老年髋部骨折患者中的应用  

Effects of early bed-out intervention based on enhanced recovery after surgery in elderly patients with hip fracture

作　　者：蒋超英[1] 王慧[2] 黄卫平[1] 李华珍[1] Jiang Chaoying;Wang Hui;Huang Weiping;Li Huazhen(Department of Comprehensive Orthopedics,Zhejiang Taizhou Hospital,Taizhou 317000,China)

机构地区：[1]浙江省台州医院综合骨科,317000 [2]浙江省台州医院血管外科,317000

出　　处：《中华现代护理杂志》2020年第12期1642-1645,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨基于加速康复外科(enhanced recovery after surgery,ERAS)理念的早期离床干预在老年髋部骨折患者中的临床应用效果。方法选取浙江省台州医院2017年1月-2018年12月收治的80例老年髋部骨折患者,依据随机数字表法分为观察组和对照组,每组各40例。对照组开展常规护理干预,观察组实施基于ERAS理念的早期离床干预。比较两组患者2周内不良事件发生情况,包括肺部感染、腹部胀痛、便秘等;评价两组患者术后的髋关节功能、日常生活能力及生活质量。结果观察组患者的肺部感染、泌尿系感染、腹胀、便秘及下肢DVT发生率低于对照组,总并发症发生率差异有统计学意义(P<0.05)。观察组术后的髋关节功能评分、日常生活能力评分、生活质量评分均高于对照组,差异有统计学意义(P<0.05)。结论对老年髋部骨折患者应用基于ERAS理念的早期离床干预能降低术后不良事件的发生率,改善其髋关节功能,提高日常生活能力和生活质量。Objective To explore the clinical effects of early bed-out intervention based on enhanced recovery after surgery(ERAS)in elderly patients with hip fracture.Methods Totally 80 patients with hip fracture admitted in Zhejiang Taizhou Hospital from January 2017 to December 2018 were selected and divided into observation group(n=40)and control group(n=40)according to the random number table.Patients in the control group received conventional nursing care,while patients in the observation group received early ERAS-based bed-out interventions.The incidence of adverse events,including pulmonary infection,abdominal pain and constipation,was compared between the two groups within 2 weeks.Postoperative hip joint function,daily living activities and quality of life were evaluated in the two groups.Results The incidence of pulmonary infection,urinary tract infection,bloating,constipation and deep vein thrombosis(DVT)in lower limbs in the observation group was lower than that in the control group,and the difference of total complication rate was statistically significant(P<0.05).The hip joint function,daily life activity and quality of life scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Early ERAS-based bet-out interventions taken for elderly patients with hip fracture can reduce the incidence of postoperative adverse events,and improve their hip joint function,daily activities and quality of life.

关 键 词：髋骨折 老年人 加速康复外科 离床 生活质量 不良事件 髋关节功能 

分 类 号：R473[医药卫生—护理学]