基于加速康复外科理念的围术期护理在青壮年股骨颈骨不连患者中的应用  

Application of perioperative nursing based on the concept of enhanced recovery after surgery in young and middleaged patients with femoral neck nonunion

作　　者：赵万秋 毕叶 林晓碧 周琴 崔蕾 徐永清 江珉 ZHAO Wanqiu;BI Ye;LIN Xiaobi;ZHOU Qin;CUI Lei;XU Yongqing;JIANG Min(th Hospital of PLA Joint Logistics Support Force,Kunming,650032,China)

机构地区：[1]中国人民解放军联勤保障部队第九二〇医院骨科,云南省昆明市650032

出　　处：《护理实践与研究》2022年第20期3013-3017,共5页Nursing Practice and Research

基　　金：云南省卫健委临床中心建设重大项目(编号:ZX20191001);云南省科技厅第三批临床医学研究中心项目(编号:202102AA310068)。

摘　　要：目的探讨基于加速康复外科理念的围术期护理在青壮年股骨颈骨不连患者中的应用效果。方法纳入2016年1月—2021年6月医院收治的100例行股方肌骨瓣联合内固定术的青壮年股骨颈骨不连患者为研究对象,按照组间基本资料匹配的原则分为观察组和对照组,各50例。对照组患者术前、术后实施常规骨科护理,观察组患者在对照组基础上实施基于加速康复外科理念的围术期护理。采用疼痛视觉模拟评分(VAS)、Harris髋关节功能评分(Harris评分)、舒适状况量表(GCQ)评价两组患者的疼痛情况、髋关节功能情况、舒适度,同时比较两组患者并发症的发生率。结果两组患者VAS评分组间比较差异具有统计学意义(P_(组间)<0.05);两组患者VAS评分随干预时间延长、逐渐降低,时间间比较差异有统计学意义(P_(时间)<0.05);且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。两组患者Harris评分组间比较差异具有统计学意义(P_(组间)<0.05);两组患者Harris评分随干预时间延长、逐渐升高,时间间比较差异有统计学意义(P_(时间)<0.05);且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。观察组患者生理、心理、社会文化、环境及GCQ总分均高于对照组,差异有统计学意义(P<0.05)。观察组患者切口感染、深静脉血栓、泌尿系感染、股骨颈短缩等并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论将基于加速康复外科理念的围术期护理应用于青壮年股骨颈骨不连患者行股方肌骨瓣联合内固定术后,可减少术后并发症发生率,降低疼痛程度,提高患者舒适度,促进患者康复。Objective To explore the application effect of perioperative nursing based on the concept of enhanced recovery after surgery in young and middle-aged patients with femoral neck nonunion.Methods To include 100 young and middle-aged patients with femoral neck nonunion who were treated in the hospital from January 2016 to June 2021 and underwent quadratus femoris bone fl ap combined with internal fi xation as the study objects,and they were divided into an observation group and a control group,with 50 cases in each according to the principle of matching the basic data between the groups.The patients in the control group were given routine orthopaedic nursing before and after surgery,and the patients in the observation group were given perioperative nursing based on the concept of enhanced recovery after surgery on the basis of the control group.Visual analogue scale(VAS),Harris hip function score(Harris score)and general comfort questionnaire(GCQ)were used to evaluate the pain,hip function and comfort of the two groups of patients,and the incidence of complications was compared between the two groups.Results The dif ference in VAS score between the two groups was statistically signifi cant(P<0.05);the VAS scores of the two groups of patients decreased gradually with the prolongation of the intervention time,and the time dif ference was statistically signifi cant(P<0.05);and as the observation time prolonged,the dif ference between the groups gradually increased,and the dif ference was statistically signifi cant(P<0.05).The dif ference in Harris score between the two groups was statistically signifi cant(P<0.05);the Harris scores of the two groups increased gradually with the prolongation of the intervention time,and the time dif ference was statistically signifi cant(P<0.05);and as the observation time prolonged,the dif ference between the groups gradually increased,and the dif ference was statistically signifi cant(P<0.05).The physical,psychological,sociocultural,environmental and GCQ total scores of the patients i

关 键 词：股骨颈骨折 骨不连 股方肌骨瓣 围术期护理 加速康复外科 综合康复护理 

分 类 号：R473.6[医药卫生—护理学]