循证干预配合克氏针撬拨辅助闭合复位在儿童难复性肱骨髁上骨折治疗中的应用  

Application effect of evidence-based nursing intervention combined with Kirschner wire prying-assisted closed reduction on the treatment of irreducible supracondylar humeral fractures in children

作　　者：李程 张慧园 王伟 李艳 李晓薇 梁丽伟 LI Cheng;ZHANG Huiyuan;WANG Wei(Department of Orthopedics and Traumatology of Traditional Chinese Medicine,Zhang Jia Kou Shi No.2 Hospital,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北省张家口市第二医院中医骨伤科,075000

出　　处：《河北医药》2023年第21期3300-3303,共4页Hebei Medical Journal

基　　金：张家口市重点研发计划项目(编号:1911023D)。

摘　　要：目的探讨儿童难复性肱骨髁上骨折采取克氏针撬拨辅助闭合复位治疗配合循证护理干预的价值。方法选自2020年7月至2021年7月就诊88例难复性肱骨髁上骨折儿童,依照随机数表法分为对照组和观察组,每组44例。所有儿童均接受克氏针撬拨辅助闭合复位治疗,对照组给予传统护理,观察组给予循证干预。分析2组织临床恢复优良率、并发症发生率、疼痛评分、肢体功能等指标。结果观察组临床恢复优良率为95.45%高于对照组的77.27%(P<0.05)。2组护理前疼痛评分比对无统计学差异(P>0.05),护理后,与对照组比较,观察组疼痛评分较低,组间比较差异显著(P<0.05);2组术前肩关节功能评分无显著差异(P>0.05),观察组患儿术后6个月时的肩关节功能包括疼痛、主动活动范围、日常生活活动、肌力评分显著优于对照组(P<0.05)。观察组患儿术后6个月时的肘关节功能包括疼痛、稳定性、日常活动、运动功能评分显著优于对照组(P<0.05)。观察组并发症发生率为4.55%低于对照组的20.45%,差异有统计学意义(P<0.05)。结论在难复性肱骨髁上骨折儿童治疗中,给予克氏针撬拨辅助闭合复位治疗,手术操作简便,较小的创伤性,融入循证护理干预,恢复优良率更高,疼痛更小,对儿童给予循证护理指导,有利于改善患儿肢体功能,减少并发症发生,值得推广借鉴。Objective To explore the value of Kirschner wire prying-assisted closed reduction combined with evidence-based nursing intervention in children with irreducible supracondylar humeral fractures.Methods A total of 88 children with irrecoverable supracondylar humeral fractures from July 2020 to July 2021 were recruited.They were randomly divided into control group and observation group,with 44 cases per group.All children received Kirschner wire prying-assisted closed reduction treatment.Conventional nursing and evidence-based nursing intervention were given to patients in the control group and the observation group,respectively.The excellent and good rate of clinical recovery,incidence of complications,pain score,limb function and other indicators were compared.Results The excellent and good rate of clinical recovery in the observation group was significantly higher than that of the control group(95.45% vs 77.27%,P0.05).There was no significant difference in the pain score before nursing between the two groups(P0.05),which,after nursing,was significantly lower in the observation group than that of the control group(P0.05).There was no significant difference in preoperative shoulder function scores between the two groups(P0.05),which,at 6 months postoperatively,including the scores of pain,active range of motion,activities of daily living and muscle strength were significantly better in the observation group than those of the control group(P0.05).The elbow function scores at 6 months postoperatively,including the pain,stability,daily activities and motor function were significantly better in the observation group than those of control group(P0.05).The incidence of complications was significantly lower in the observation group than that of the control group(4.55% vs 20.45%,P0.05).Conclusion Kirschner wire prying-assisted closed reduction on the treatment of irreducible supracondylar humeral fractures in children is featured by simple procedures and less trauma.Its combination with evidence-based nursing intervention

关 键 词：循证干预模式 克氏针撬拨 闭合复位 儿童 难复性肱骨髁上骨折 

分 类 号：R726.831.13[医药卫生—儿科]