自制多孔侧卧位固定架在降低老年髋关节置换术压疮风险临床研究  

Clinical study of self-made porous lateral decubitus fixator for reducing risk of pressure ulcers in elderly hip replacement

作　　者：陈娟 陈兰 王勤 CHEN Juan;CHEN Lan;WANG Qin(Department of Orthopedic Operating Room,Tongling Municipal Hospital,Tongling 244000,Anhui,China)

机构地区：[1]铜陵市立医院手术室,安徽铜陵244000

出　　处：《生物医学工程与临床》2022年第1期76-80,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的评价应用自制多孔侧卧位固定架对减少老年髋关节置换术患者术后压疮发生率的有效性。方法选择2018年7月至2020年7月在铜陵市立医院确诊的GardenⅢ、Ⅳ型股骨颈骨折行侧卧位人工髋关节置换手术的70例患者,其中男性21例,女性49例;年龄65~90岁,平均年龄77.19岁;半髋置换52例,全髋置换18例。按照随机数字表法分为对照组和试验组,每组35例。自制多孔侧卧位固定架。对照组术中使用传统侧卧位骨盆金属固定架固定。试验组采用自制多孔侧卧位固定架进行固定。将两组病例的术前侧卧位安放时间、手术操作时间及术后即刻压疮发生的情况进行比较。结果试验组术前体位安放时间(7.23±8.07) min,优于对照组(14.56±7.52) min,差异有统计学意义(P <0.05);两组患者手术操作时间比较,差异无统计学意义(P> 0.05)。术后试验组早期(1、2期)压疮发生的情况明显少于对照组。两组术后1期压疮,对照组5例(14.29%),试验组1例(2.86%);两组比较,差异有显著统计学意义(χ^(2)=9.032,P=0.003 <0.01)。2期压疮,对照组3例(8.57%),试验组1例(2.86%);两组比较,差异有统计学意义(χ^(2)=6.355,P=0.025 <0.05)。结论应用自制多孔侧卧位固定架可有效缩短老年侧卧位人工髋关节置换体位安放时间,降低术后早期(1、2期)压疮发生率。Objective To evaluate effectiveness of self-made porous lateral decubitus fixator for reducing postoperative pressure ulcers in elderly hip replacement. Methods From July 2018 to July 2020, 70 patients who performed lateral artificial hip replacement of Garden Ⅲ and Ⅳ femoral fractures were enrolled, which included 21 males and 49 females, aged 65-90 years old with mean age of 77.19 years old;52 cases of hemi hip replacement and 18 of total hip replacement. All of them were divided into control group and experimental group by random number table method(n = 35). The control group was fixed with traditional lateral pelvic metal fixator and the experimental group was fixed with self-made porous lateral decubitus fixa-tor. The preoperative lateral placement time, operation time and immediate postoperative pressure ulcer were compared between 2 groups. Results The preoperative lateral placement time in experimental group[(7.23 ± 8.07) minutes] was statistically significantly better than that in control group [(14.56 ± 7.52) minutes](P < 0.05). There was no significant difference in operation time between 2 groups(P > 0.05). The pressure ulcer in the early stage(stage 1 and 2) of experimental group was significantly less than that of control group. In stage 1, there were 5 cases(14.29 %) in control group and 1 case(2.86 %) in experimental group, which was significant difference between 2 groups(χ^(2)= 9.032, P = 0.003 < 0.01). In stage 2, there were3 cases in control group(8.57 %) and 1 case(2.86 %) in experimental group, which was significant difference between 2 groups(χ^(2)= 6.355, P = 0.025 < 0.05). Conclusion It is demonstrated that the self-made porous lateral decubitus fixator could effectively shorten preoperative lateral placement time and decrease incidence of pressure ulcer in the early stage(stage 1, stage 2).

关 键 词：髋部骨折 髋关节成形术 骨盆固定架 体位护理 压力性损伤 

分 类 号：R687.42[医药卫生—骨科学] R632.1[医药卫生—外科学]