标准化手术护理在高龄患者行股骨近端抗旋髓内钉手术中的临床观察  

Clinical observation of standardized surgical nursing in elderly patients undergoing proximal femoral nail antirotation operation

作　　者：邱苓 陆建平[1] 林伟龙[2] 范永前[2] 陈爱东 史怡 Qiu Ling;Lu Jianping;Lin Weilong;Fan Yongqian;Chen Aidong;Shi Yi(Department of Operation Room,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Orthopaedics,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院手术室,上海200040 [2]复旦大学附属华东医院骨科,上海200040

出　　处：《老年医学与保健》2020年第5期873-877,共5页Geriatrics & Health Care

摘　　要：目的观察标准化手术护理在高龄患者行股骨近端抗旋髓内钉(PFNA-II)手术中的应用效果,为患者术后康复提供方法。方法回顾性分析2018年1月-2019年12月在华东医院骨科行PFNA-II手术的100例高龄患者的临床资料,依据不同的护理方法分为观察组(n=51)和对照组(n=49)。观察组术中采取标准化手术护理,对照组术中采取普通手术流程护理。评估并比较2组手术相关指标,应用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)分别评估患者焦虑和抑郁状况,观察并比较2组患者术后并发症发生情况、骨折愈合时间和髋关节功能(Harris评分)情况。结果观察组术前准备时间、手术时间、首次下床活动时间和术中出血量均明显少于对照组,差异均有统计学意义(P<0.05)。术前2组HAMA和HAMD评分比较差异均无统计学意义(P>0.05),术后2组HAMA和HAMD评分明显低于同组术前,且观察组术后HAMA和HAMD评分均明显低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组(5.88%20.41%)(P<0.05)。观察组术后骨折愈合时间明显少于对照组(P<0.05)。2组术后6个月Harris评分均明显高于同组术前(P<0.05),而2组间Harris评分无统计学差异(P>0.05)。结论在高龄患者行PFNA-II术中应用标准化手术护理取得较好的临床效果,可优化患者手术相关指标,改善患者焦虑与抑郁,促进骨折愈合,具有一定的应用价值。Objective To explore the application effect of standardized surgical nursing in elderly patients undergoing proximal femoral nail antirotation(PFNA-II)operation.Methods The clinical data of 100 elderly patients who underwent PFNA-II operation in Huadong hospital from January 2018 to December 2019 were retrospectively analyzed.According to different nursing methods,they were divided into observation group(n=51)and control group(n=49).During the operation,the observation group was given standardized surgical nursing,while the control group was given ordinary surgical procedure nursing.The operation related indexes were evaluated and compared between the two groups.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the anxiety and depression of patients.The incidence of postoperative complications,fracture healing time and hip joint function(Harris score)were observed and compared between the two groups.Results The preoperative preparation time,operation time,first out of bed time and intraoperative blood loss of the observation group were significantly less than those of the control group(P<0.05).There was no significant difference in HAMA and HAMD scores between the two groups before operation(P>0.05).The HAMA and HAMD scores of the two groups after operation were significantly lower than those of the same group before operation,and the postoperative HAMA and HAMD scores of the observation group were significantly lower than those of control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(5.88%vs 20.41%)(P<0.05).The fracture healing time of the observation group was significantly less than that of the control group(P<0.05).Harris scores of the two groups at 6 months after surgery were significantly higher than those of the same group before surgery(P<0.05),but there was no statistical difference in Harris scores between the two groups(P>0.05).Conclusion The application of standardized operation nursing in elderly patie

关 键 词：高龄 股骨近端抗旋髓内钉 标准化手术 护理 

分 类 号：R473.6[医药卫生—护理学]