整体化护理在老年股骨粗隆间骨折患者中应用的比较研究

An application of holistic nursing to prevent pressure sores in elderly femoral intertrochanteric fracture patients

目的探讨整体护理干预在老年股骨粗隆间骨折压疮预防中效果及对手术应激反应的影响。方法选择老年股骨粗隆间骨折患者92例为研究对象,均采用手术内固定治疗。根据入院先后随机分为整体护理干预组和对照组,对比分析两组患者围手术期血压、心率及焦虑、抑郁情绪的变化,术后康复期压疮的发生率及住院时间的差异。结果整体护理干预组压疮发生率明显低于对照组(χ2=5.785,P=0.016)。整体护理干预组患者术前1 h收缩压、舒张压及心率与入院时无显著性差异,而对照组收缩压、舒张压较入院时明显升高(t=4.284,P<0.001;t=3.789,P<0.001),心率明显加快(t=2.956,P=0.004)。术后1周整体护理干预组患者HAMA及HAMD评分均较入院时明显降低(t=4.919,P<0.001;t=6.446,P<0.001),平均住院时间较对照组明显缩短(t=5.841,P<0.001)。结论整体护理干预能有效降低老年股骨粗隆间骨折患者压疮的发生率,缓解患者焦虑、抑郁等不良应激反应,促进患者功能康复,减轻患者及家庭负担,在老年股骨粗隆间骨折患者围手术期护理中具有重要作用,值得临床推广。

Objective To evaluate the effects of holistic nursing in preventing pressure sores in elderly femoral intertrochanteric fracture patients.Method 92 the elderly femoral intertrochanteric fracture patients admitted to our hospital in recent years were chosen as the subjects and all were treated with internal fixation.They were randomly divided into an experimental group and a control group.The change of perioperative blood pressure,heart rate,anxiety and depression,the difference of the pressure sores incidence in postoperative recovery period and length of hospital stay were analyzed.Results Incidence of pressure sores in the experimental group was obviously lower than that of the control group（χ2=5.785,P=0.016）.There was no significant difference in systolic pressure,diastolic blood pressure and heart rate between preoperative 1 h and be in hospital（t=1.501,P=0.137;t=0.696,P=0.488;t=1.154,P=0.252）,and control group in systolic pressure,diastolic blood pressure increased significantly（t=4.284,P0.001;t=3.789,P0.001）,the heart rate was significantly speed up（t=2.956,P=0.004）.1 week after the operation,HAMA and HAMD scores of overall nursing intervention group patients were significantly lower than be in hospital（t=4.919,P0.001;t=6.446,P0.001）;HAMA and HAMD scores of control group patients were slightly lower than be in hospital,but there was no statistically significant difference（t=1.308,P=0.194;t=1.377,P=0.172）.The average length of hospital stay of overall nursing intervention group patients was significantly shorter than the control group（t=5.841,P0.001）.Conclusion Holistic nursing can effectively reduce the incidence of pressure sores in elderly femoral intertrochanteric fracture patients,alleviate the patient anxiety,depression and other negative stress reaction,promote the patients functional recovery,reduce the financial burden on the patient and family,and thus plays an important role in perioperative nursing of elderly femoral intertrochanteric fracture patients.