人工股骨头置换术治疗高龄骨质疏松性股骨粗隆间骨折患者的护理

Nursing of elderly patients with osteoporotic intertrochanteric fracture of femur undergoing artifi-cial femoral head replacement

目的探讨人工股骨头置换术治疗老年骨质疏松性股骨粗隆间骨折的护理方法及疗效。方法选择我院2007年2月至2011年2月收治的55例老年骨质疏松性股骨粗隆间骨折患者，对所有患者均进行针对性的术前、术后护理，及时辅导患者进行功能锻炼，并进行出院指导，对患者进行随访。根据髋关节功能评分标准（Harris评分）评价患者术后髋关节功能恢复情况，并评价手术的优良率。结果55例患者经过针对性的护理后均安全度过围手术期，平均住院时间（14．0±3．1）d，术后共有5例占9．09％的患者发生不同程度的并发症，经对症处理后均好转，术后随访3-36个月，除2例死于脑血管意外，所有患者的髋关节功能恢复情况良好。Harris评分为（84．45±9．38）分，手术优良率达78．18％。结论人工股骨头置换术对治疗老年骨质疏松性股骨粗隆间骨折的疗效明显，但由于手术并发症的存在，需注意其特殊的护理方法和及时的功能锻炼。

Objective To summarize the nursing methods and effect of artificial femoral head re- placement in treatment of osteoporotic intertrochanteric fracture in elderly patients. Methods 55 patients with osteoporotic intertrochanteric fracture were selected in our hospital from February 2007 to February 2011. All patients were cared by targeted preoperative and postoperative nursing, helping them conducting functional training in time, giving discharge counseling and follow-up. The hip functional recovery of pa- tients was evaluated by using the Harris evaluation standard, and the excellent rate of surgery was also e- valuated. Results After the targeted care, 55 patients went through the perioperative period safely, the average length of stay was （14.0 ~ 3.1 ）days, a total of 5 cases （9.09%）patients suffered varying degrees of complications which were improved after symptomatic treatment. Patients were followed up for 3 to 36 months, only 2 patients died of cerebral vascular accident, all patients gained good recovery of hip function. Harris score was （84.45 ＋ 9.38）, the excellent rate of surgery reached 78.18%. Conclusions Artificial femoral head replacement proves significant effect in treatment of osteoporotic intertrochanteric fractures in elderly patients, but with the accompanying surgical complications, special care and timely functional exer- cise methods should be paid attention to.