快速康复外科理念结合个案管理模式在髋关节置换术患者围术期护理中的应用效果研究

Study on the Application Effect of Fast Rehabilitation Surgery Concept Combined with Case Management Model in Perioperative Nursing of Patients with Hip Joint Replacement

目的探讨快速康复外科理念结合个案管理模式在髋关节置换术患者围术期护理中的应用效果.方法选取2020年1月—2021年6月我院收治的86例髋关节置换术患者为研究对象,按护理方法不同分为对照组(43例)和观察组(43例).对照组采用常规护理,观察组采用快速康复外科理念结合个案管理模式.两组均随访至术后3个月,对比两组术后疼痛程度、机体恢复情况、并发症发生率、髋关节功能及护理满意度.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,观察组VAS评分(1.38±0.31)分低于对照组的(2.04±0.48)分,差异有统计学意义(P<0.05).观察组术后肛门排气时间、下床活动时间及住院时间分别为(24.13±3.50)h、(2.50±0.62)d、(8.98±1.90)d,均短于对照组的(30.53±4.27)h、(4.07±0.87)d、(12.12±2.07)d,组间差异有统计学意义(P<0.05).观察组并发症发生率为4.65%,低于对照组的18.60%,差异有统计学意义(P<0.05).术前,两组Harris髋关节功能评分量表评分比较,差异无统计学意义(P>0.05);术后3个月,观察组疼痛评分(31.32±2.45)分、关节活动度评分(2.53±0.16)分、关节功能评分(38.36±1.74)分、关节畸形评分(2.60±0.15)分均高于对照组的(28.28±2.77)分、(2.11±0.24)分、(35.65±1.32)分、(2.32±0.23)分,组间差异有统计学意义(P<0.05).观察组护理满意度为95.35%,高于对照组的79.07%,差异有统计学意义(P<0.05).结论快速康复外科理念结合个案管理模式能够减轻髋关节置换术患者术后疼痛,预防并发症,加快术后恢复,促进髋关节功能改善,从而使患者获得更高的护理满意度.

Objective To explore the application effect of the concept of fast rehabilitation surgery combined with case management model in the perioperative nursing of patients with hip joint replacement.Methods A total of 86 patients with hip joint replacement who were treated in our hospital from January 2020 to June 2021 were selected as the research objects,and divided into a control group(43 cases)and an observation group(43 cases)according to different nursing methods.The control group was given routine nursing,while the observation group was given the concept of fast rehabilitation surgery combined with case management mode.Both groups were followed up to 3 months after operation,and the postoperative pain degree,body recovery,complication rate,hip function and nursing satisfaction were compared between the two groups.Results At 6 hours after operation,there was no significant difference in pain visual analog scale(VAS)between the two groups(P>0.05);at 72 hours after operation,the VAS score of the observation group was(1.38±0.31)points,which was lower than(2.04±0.48)points of the control group,and the difference was statistically significant(P<0.05).The postoperative anal exhaust time,time to get out of bed and hospital stay in the observation group were(24.13±3.50)h,(2.50±0.62)d,and(8.98±1.90)d,respectively,which were shorter than(30.53±4.27)h,(4.07±0.87)d,(12.12±2.07)d of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 4.65%,which was lower than 18.60%in the control group,and the difference was statistically significant(P<0.05).Before operation,there was no significant difference in Harris hip score between the two groups(P>0.05);3 months after operation,the pain score of the observation group was(31.32±2.45)points,the range of motion score(2.53±0.16)points,the joint function score(38.36±1.74)points,and the joint deformity score(2.60±0.15)points were higher than(28.28±2.77)points,(2.11±0.24)points,(35.65±1.32)points,and(2.32±0.23)points of the control group,and the differences between the groups were statistically significant(P<0.05).The nursing satisfaction of the observation group was 95.35%,which was higher than 79.07%of the control group,and the difference was statistically significant(P<0.05).Conclusion The concept of fast rehabilitation surgery combined with the case management model can reduce postoperative pain,prevent complications,speed up postoperative recovery,and improve hip joint function in hip joint replacement patients,so that patients can achieve higher nursing satisfaction.