基于流行病学分析的优化护理安全管理对老年髋部骨折住院患者的应用价值  

The epidemiological characteristics in elderly patients with hip fracture and optimized nursing safety management strategy

作　　者：张亚辉[1] 闫晓丽[2] 魏秀敏 鹿青[3] 李媛 贾一娇 王秋筠[1] ZHANG Yahui;YAN Xiaoli;WEI Xiumin(Operating Room,The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China;不详)

机构地区：[1]河北医科大学第三医院日间手术部,石家庄市050051 [2]河北医科大学第三医院骨科中心,石家庄市050051 [3]河北医科大学第三医院骨伤科,石家庄市050051 [4]河北医科大学第三医院老年骨科,石家庄市050051

出　　处：《河北医药》2021年第7期1103-1107,共5页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20201022)。

摘　　要：目的回顾性分析医院5046例老年髋部骨折住院患者的流行病学特征,根据相关的合并症、并发症提出针对性、优化的的护理安全管理策略。方法利用医学影像计算机存档与传输系统及病案查询系统收集2016年1月至2019年12月住院诊治的所有老年髋部骨折患者资料,描述患者的性别、年龄、发病季节、合并症等流行病学资料,总结老年髋部骨折住院患者的流行病学特征并在此基础上提出相应的护理安全管理策略。结果共收集7207例髋部骨折住院患者,年龄2~106岁,平均年龄69.8岁;其中年龄≥65岁的患者为5046例(70.0%);老年髋部骨折患者中,年龄65~106岁,平均年龄77.9岁。其中男1603例(31.8%),女3443例(68.2%),男∶女=1∶2.15,差异有统计学意义(P<0.05)。老年髋部骨折患者根据骨折部位划分:股骨粗隆骨折2513例(49.8%),股骨颈骨折2533例(50.2%),不同年限骨折类型比较差异无统计学意义(P>0.05)。将患者的住院时间按照季节统计,春季发病1160例(23.0%),夏季发病1267例(25.1%),秋季发病1361例(27.0%),冬季发病1258例(24.9%);88.8%的患者合并基础疾病,患病率>10%的疾病由高到低依次为:高血压(49.8%),营养不良(40.8%),脑血管疾病(39.8%),心血管疾病(38.7%),糖尿病(22.9%),电解质紊乱(18.9%),骨质疏松(11.7%),呼吸系统疾病(10.7%)。5046例老年髋部骨折住院患者中,各系统并发症发生情况,由高到低依次为:便秘(57.0%),双下肢深静脉血栓(31.2%):其中肌间静脉血栓(62.8%),行滤器植入(2.3%);肺部感染(8.5%);泌尿系感染(2%);皮肤压力性损伤(0.7%)。结论髋部骨折多见于老年人,且以女性居多,秋季为老年髋部骨折发病高发季节,对高危人群、高发季节做好针对性健康宣教有效预防跌倒发生;在此基础上给予个体化营养支持,积极控制基础疾病,预防并发症的发生是老年髋部骨折患者康复的关键。Objective To retrospectively analyze the epidemiological characteristics of 5046 elderly inpatients with hip fracture,and to put forward the targeted and optimized nursing safety management strategies according to the related complications.Methods The medical image computer archiving and transmission system as well as medical record query system were used to collect the clinical data of the elderly patients with hip fracture who were treated in our hospital from January 2016 to December 2019,including patient’s gender and age,onset season,complications and other epidemiological data,and the epidemiological characteristics were summarized.On this basis,the corresponding nursing safety management measures were put forward.Results A total of 7,207 inpatients with hip fracture(2~106 years of age,mean 69.8 years)were collected,of whom,5,046 patients(70.0%)were more than 65 years of age.Among the elderly patients with hip fracture,the mean age was 77.9 years,there were 1,603 males(31.8%)and 3,443 females(68.2%),and the ratio of males to females was 1∶2.15,there was significant difference(P<0.05).According to the fracture site,there were 2,513 cases of femoral trochanteric fracture(49.8%)and 2,533 cases of femoral neck fracture(50.2%).According to the time of admission,1,160 cases(23.0%)occurred in spring,1,267 cases(25.1%)in summer,1,361 cases(27.0%)in autumn and 1,258 cases(24.9%)in winter.And 88.8%of the patients were complicated with basic diseases,and the diseases with the prevalence of more than 10%were hypertension(49.8%),malnutrition(40.8%),cerebrovascular disease(39.8%),cardiovascular disease(38.7%),diabetes mellitus(22.9%),electrolyte disorder(18.9%),osteoporosis(11.7%)and respiratory diseases(10.7%).Of the 5,046 elderly patients with hip fracture,the incidence rates of complications were in order(from high to low)constipation(57%),deep venous thrombosis of both lower extremities(31.2%)which including intermuscular venous thrombosis(62.8%)and filter implantation(2.3%),pulmonary infection(8.5%),urinary syst

关 键 词：老年人 髋部骨折 流行病学 合并症及并发症 护理安全管理 

分 类 号：R473.6[医药卫生—护理学]