不同围手术期护理策略在老年骨质疏松性胸腰椎压缩性骨折经皮椎体成形术患者中的应用效果

Application effects of different perioperative nursing strategies on elderly patients with osteoporotic thoracolumbar compression fractures undergoing percutaneous vertebroplasty

目的对比整体护理、优质护理2种围手术期护理策略在老年骨质疏松性胸腰椎压缩性骨折经皮椎体成形术(PVP)患者中的应用效果。方法选择徐州医科大学附属医院2019年4月至2020年10月收治的86例老年骨质疏松性胸腰椎压缩性骨折患者,采用便利抽样法分为观察组、对照组,各43例。观察组患者接受围手术期整体护理,对照组患者接受围手术期优质护理。对比2组患者的术后恢复情况和围手术期腰背部疼痛视觉模拟评分法(VAS)评分变化,并评价2组患者在术前、术后1个月、术后3个月的Barthel指数(BI)、日本骨科协会(JOA)评分和Oswestry功能障碍指数(ODI)的变化。结果与对照组比较,观察组的下床时间更早、住院时间更短(P均<0.05)。相较于术前,2组在术后1 d、3 d和1个月的VAS评分均降低(P均<0.05),观察组在术后1 d、术后3 d的VAS评均较对照组更低(P均<0.05)。术后1个月和3个月,2组的BI、JOA评分均较术前升高,ODI均降低(P均<0.05);观察组在术后1个月的BI、JOA评分均高于对照组,ODI低于对照组(P均<0.05)。结论相较于优质护理而言,整体护理在促进老年骨质疏松性胸腰椎压缩性骨折患者PVP术后恢复、减轻术后疼痛、改善功能状态方面应用价值更高。

Objective To compare the application effects of holistic nursing and high-quality nursing strategies on elderly patients with osteoporotic thoracolumbar compression fractures undergoing percutaneous vertebroplasty(PVP)during perioperative period.Methods Eighty-six elderly patients with osteoporotic thoracolumbar compression fractures treated in the Affiliated Hospital of Xuzhou Medical University from April 2019 to October 2020 were selected.They were divided into two groups by convenience sampling,with the observation group receiving perioperative holistic nursing and the control group receiving perioperative high-quality nursing.Both groups contained 43 cases.The postoperative recovery and perioperative changes in visual analogue scale(VAS)scores for back pain were compared between the two groups,and the scores of Barthel index(BI),Japanese Orthopedic Association(JOA),and Oswestry disability index(ODI)were evaluated before operation,1 month after operation,and 3 months after operation.Results Compared with the control group,the observation group had shorter ambulation time and hospital stays(both P<0.05).Compared with before operation,the VAS scores of the two groups decreased at 1 day,3 days,and 1 month after operation(all P<0.05),and the VAS scores of the observation group at 1 and 3 days after operation were lower than those of the control group(both P<0.05).At 1 and 3 months after operation,the BI and JOA scores of the two groups were higher than those before operation,and the ODI scores were lower(all P<0.05).At 1 month after operation,the BI and JOA scores of the observation group were higher than those of the control group,and the ODI scores were lower than those of the control group(all P<0.05).Conclusion Compared with high-quality nursing,holistic nursing has higher application value in promoting the postoperative recovery of PVP,relieving the postoperative pain,and improving the functional status in elderly patients with osteoporotic thoracolumbar compression fractures.