高龄粗隆间骨折患者PCCP围术期的护理

Perioperative care of elderly intertrochanteric fracture patients by percutaneous compression plating

目的:探讨股骨粗隆间骨折的高龄患者经皮加压钢板(PCCP)内固定治疗的临床效果和围术期护理对策。方法:将128例高龄股骨粗隆间骨折患者随机分为PCCP组和DHS组,每组64例,PCCP组患者采用经皮加压钢板(PCCP)内固定治疗,DHS组采用动力髋部螺纹钉(DHS)治疗。通过比较两种方法的治疗效果总结PCCP手术的特点以及PCCP手术围术期护理的注意事项。结果:所有患者均获得满意疗效,PCCP组手术时间为(48.6±17.8)min,创口大小为(8.2±1.5)cm,出血量为(88.6±34.7)ml,平均愈合时间为(13.4±1.2)周;DSH组手术时间为(85.2±22.2)min,创口大小为(14.9±2.1)cm,出血量为(245.3±123.7)ml,平均愈合时间为(14.3±1.2)周。两组手术时间、创口大小、出血量方面上比较,差异具有统计学意义(P<0.05或P<0.01)。PCCP组患者术后未发生切口感染、深静脉血栓、压疮、骨折不愈合、钢板螺钉断裂等并发症。结论:PCCP技术是治疗高龄患者股骨粗隆间骨折的有效方法,认真做好每一个护理环节,加强患者围手术护理是确保高龄患者平稳度过手术期的前提。

Objective： To investigate the clinical therapeutic efficacy of percutaneous compression plating（PCCP） in the treatment of elderly intertrochanteric fracture patients and to explore the perioperative nursing strategy.Methods： 128 cases of elderly intertrochanteric fracture patients were randomly divided into PCCP group and dynamic hip screw（DHS） group,with 64 cases in each group.Patients in PCCP group were treated with percutaneous compression plating and patients in DHS group were given dynamic hip screw treatment.The characteristics of PCCP surgery and its perioperative nursing considerations were summarized through comparing the therapeutic efficacy of the two methods.Results： All patients achieved satisfatory treatment outcomes.Specifically,in the PCCP group,operative time was（48.6 ±17.8） min,wound size was（8.2±1.5） cm,the amount of bleeding was（88.6±34.7） ml and the average healing time was（13.4±1.2） weeks.In the DSH group,operative time was（85.2±22.2） min,wound size was（14.9±2.1） cm,the amount of bleeding was（245.3±123.7） ml and the average healing time was（14.3±1.2） weeks.There were significant differences between the outcomes of the two groups in operative time,wound size and the amount of bleeding（P0.05 or P0.01）.Patients in the PCCP group didn＇t demonstrate complications such as wound infection,deep vein thrombosis,pressure ulcers,delayed healing of fracture healing and plate and screw fracture.Conclusion： PCCP technique is an effective treatment for elderly intertrochanteric fracture patients.Stable progression through the surgery demands attention to every aspect of perioperative patient care.