应用护理指引预防全髋关节置换术后脱位的探讨

Application of nursing guidelines in prevention of hip dislocation after total hip replacement

目的 探讨应用护理指引预防全髋关节置换术后脱位的效果,降低人工髋关节置换术后假体脱位的发生.方法 将2003年1月至2009年8月收治的人工全髋关节置换术患者160例作为对照组,2009年9至2012年1月收治的人工全髋关节置换术患者200例作为观察组,对照组采用常规的护理方法,观察组在常规护理的基础上根据广东省2009年骨科十大安全指引的预防髋关节置换术后假体脱位的护理指引进行护理.结果 两组患者在行全髋关节置换术后,发生假体脱落,观察组1例,发生率为0.5％,对照组5例,发生率为3.1％,观察组假体脱位并发症明显少于对照组（P＜0.05）,差异有统计学意义.结论 护理指引作为一种临床护理实践活动,应用于人工全髋关节置换术后患者的护理,使我们在护理活动中有根可依,有章可循,避免我们护理工作中的盲目性、主观性,有效地预防假体脱落的发生,从而提高了髋关节置换术病人的生活质量.

Objective To explore the effect of nursing guidelines in the prevention of dislocation of the hip after total hip replacement.Methods 160 patients who had undergone total hip replacement from January 2003 to August 2009 were assigned to a control group,and 200 patients who had received the same procedure from September 2009 to January 2012 were assigned to a study group.The control group received conventional nursing,while the study group received our self-designed nursing guidelines based on the Ten Safety Guidelines on Crthopedic of Guangdong in 2009 in addition to conventional nursing.Results The rate of hip dislocation after total hip replacement was obviously lower in the study group than in the control group,with a statistical significance （0.5% vs.3.1%,P〈0.05）.Conclusions Nursing guidelines are better clinical nursing ways to care for patients undergoing total hip replacement.We should follow these guidelines to avoid blindness and subjectivity in nursing practice and to prevent the occurrence of hip dislocation after total hip replacement effectively,resulting in an increase in quality of life in these patients.