基于快速康复理念的护理干预对踝关节骨折手术患者术后关节运动功能及疼痛的影响

Influence of Nursing Intervention Based on the Concept of Fast Recovery on Postoperative Joint Motor Function and Pain in Patients with Ankle Joint Fracture Surgery

目的探讨基于快速康复理念的护理干预在踝关节骨折手术患者中的应用效果.方法选取2019年5月—2021年5月我院收治的86例踝关节骨折手术患者为研究对象,按随机数字表法分为两组,各43例.对照组采用常规护理,试验组采用基于快速康复理念的护理干预.对比两组术后疼痛情况、心理状态、机体恢复情况、踝关节运动功能以及并发症发生率.结果术后6 h,两组疼痛视觉模拟评分(VAS)比较,差异无统计学意义(P>0.05);术后72 h,试验组VAS评分为(1.72±0.39)分,低于对照组的(2.42±0.54)分,差异有统计学意义(P<0.05).术前,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分比较,组间差异无统计学意义(P>0.05);术后3个月,试验组SAS、SDS评分分别为(36.02±6.29)分、(38.45±6.39)分,均低于对照组的(45.15±8.38)分、(47.78±7.45)分,组间差异有统计学意义(P<0.05).试验组术后下床活动及住院时间分别为(2.83±0.59)d、(8.45±1.17)d,均短于对照组的(4.10±0.75)d、(10.22±1.63)d,组间差异有统计学意义(P<0.05).术前,两组Mazur评分及踝关节旋前、旋后、背伸、跖屈活动度比较,组间差异无统计学意义(P>0.05);术后3个月,试验组Mazur评分为(75.62±5.04)分,高于对照组的(69.32±5.77)分,踝关节旋前、旋后、背伸、跖屈活动度分别为(18.43±2.12)°、(21.83±2.01)°、(17.59±2.38)°、(28.36±3.04)°,均大于对照组的(15.22±2.33)°、(17.26±2.34)°、(13.55±2.73)°、(24.72±2.85)°,组间差异有统计学意义(P<0.05).试验组并发症发生率为2.33%,低于对照组的18.60%,差异有统计学意义(P<0.05).结论基于快速康复理念的护理干预应用于踝关节骨折手术患者中,能够减轻其术后不良情绪及疼痛,减少并发症发生,有利于踝关节运动功能康复,加快其术后康复进程.

Objective To explore the application effect of nursing intervention based on the concept of rapid rehabilitation in patients with ankle joint fracture surgery.Methods 86 patients with ankle joint fracture surgery who were treated in the hospital from May 2019 to May 2021 were selected as the research objects,and divided into two groups according to the random number table method,with 43 cases in each group.The control group received routine nursing,and the experimental group received nursing intervention based on the concept of rapid recovery.The postoperative pain,psychological state,physical recovery,ankle ioint motor function and the incidence of complications were compared between the two groups.Results At 6 hours after operation,there was no significant difference in pain visual analog scale(VAS)score between the two groups(P>0.05);at 72 hours after operation,the VAS score of the experimental group was(1.72±0.39)points,which was lower than(2.42±0.54)points of the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference between the two groups in the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)(P>0.05);at 3 months after operation,the SAS and SDS scores of the experimental group were(36.02±6.29)points and(38.45±6.39)points,respectively,which were lower than(45.15±8.38)points and(47.78±7.45)points of the control group,respectively,and the differences between the groups were statistically significant(P<0.05).The postoperative out-of-bed activity and hospital stay in the experimental group were(2.83±0.59)d and(8.45±1.17)d,respectively,which were shorter than(4.10±0.75)d and(10.22±1.63)d in the control group,and the differences between the groups were statistically significant(P<0.05).Before operation,there was no significant difference between the two groups in Mazur score and the range of motion of pronation,supination,dorsiflexion and plantar flexion of ankle joint(P>0.05);at 3 months after operation,the Mazur score of the experimental group was(75.62±5.04)points,which was higher than(69.32±5.77)points of the control group,the range of motion of pronation,supination,dorsiflexion and plantar flexion of ankle joint were(18.43±2.12)°,(21.83±2.01)°,(17.59±2.38)°,(28.36±3.04)°,respectively,which were greater than(15.22±2.33)°,(17.26±2.34)°,(13.55±2.73)°,and(24.72±2.85)°of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the experimental group was 2.33%,which was lower than 18.60%in the control group,and the difference was statistically significant(P<0.05).Conclusion Nursing intervention based on the concept of rapid rehabilitation is applied to patients with ankle joint fracture surgery,which can reduce postoperative negative emotions and pain,reduce the occurrence of complications,facilitate the rehabilitation of ankle motor function,and speed up the postoperative rehabilitation process.