直接前入路微创全髋关节置换术的围手术期护理  

Perioperative nursing experience of minimally invasive total hip arthroplasty through the direct anterior approach

作　　者：庞晶 韩凤梅 李杰[1] 李全城 王鹏[1] PANG Jing;HAN Fengmei;LI Jie(Baoding No.1 Central Hospital,Hebei,Baoding 071000,China;不详)

机构地区：[1]河北省保定市第一中心医院,071000 [2]河北省保定市第二医院

出　　处：《河北医药》2023年第16期2542-2545,共4页Hebei Medical Journal

基　　金：保定市科学技术研究与发展计划项目(编号:18ZF285)。

摘　　要：目的探讨直接前入路微创全髋关节置换术的围手术期护理效果。方法选取2016年9月至2018年9月收治的52例行直接前入路微创全髋关节置换术的患者列入研究资料,采用Excel随机函数将患者分为对照组和研究组,分别给予其常规护理干预和围手术期护理干预,分析比较2组患者的髋关节功能、并发症发生情况、疼痛程度、睡眠质量以及生活质量。结果入院时,2组患者的Harris髋关节评分各方面差异无统计学意义(P>0.05),随访3个月后,研究组患者疼痛、功能、畸形、关节活动四个方面的得分均高于对照组患者,其Harris总分高于对照组(P<0.05);护理干预后研究组患者的深静脉血栓、肺栓塞、褥疮、感染的例数均少于对照组,其并发症发生率为3.85%,明显低于对照组患者的23.08%(χ^(2)=4.13,P=0.04);研究组组患者在术后6 h,24 h,48 h的疼痛评分均低于对照组患者,疼痛程度小于对照组(P<0.05);睡眠质量方面的比较中,护理干预后研究组患者PSQ各方面得分均低于对照组患者,其PSQI总分低于对照组(P<0.05);生活质量各方面的评分中,研究组患者均高于对照组(P<0.05)。结论对直接前入路微创全髋关节置换术患者实施围手术期的护理干预可以明显提升患者髋关节功能,降低其术后并发症的发生率以及疼痛程度,提升患者的睡眠质量和生活质量,优势显著,值得在临床大力推广使用。Objective To investigate the perioperative nursing effect of minimally invasive total hip arthroplasty through the direct anterior approach.Methods From September 2016 to September 2018,clinical data of 52 patients receiving the minimally invasive total hip arthroplasty through the direct anterior approach were retrospectively analyzed.They were randomly divided into the control group and research group using the Excel random function,and intervened by conventional nursing and perioperative nursing,respectively.The hip joint function,complications,pain level,sleep quality,and quality of life were compared between groups.Results There were no significant differences in all dimensions of the Harris hip score at admission between the two groups(P>0.05).After 3 months of follow-up,the scores of pain,function,deformity and joint activity,as well as the total Harris hip score in the research group were all significantly higher than those in the control group(P<0.05).After the nursing intervention,the case number of complications like the deep vein thrombosis,pulmonary embolism,bedsore and infections was less in the research group than those in the control group,so as the incidence of complications(3.85%vs 23.08%,χ^(2)=4.13,P=0.04).The pain scores of patients in the research group at 6h,24h and 48h postoperatively were all significantly lower than those in the control group,and the pain level was significantly lower(P<0.05).The scores of each dimension of the Pittsburgh Sleep Quality Index(PSQI),and its total score after nursing intervention were significantly lower in the research group than those in the control group(P<0.05).The scores of all dimensions of quality of life in the research group were significantly higher than those in the control group(P<0.05).Conclusion Perioperative nursing intervention for patients undergoing minimally invasive total hip arthroplasty through the direct anterior approach can significantly improve their hip function,sleep quality and quality of life,and reduce the incidence of postope

关 键 词：直接前入路 全髋关节置换术 围手术期护理 

分 类 号：R473.6[医药卫生—护理学]