骨科保护支架对胫腓骨折患者术后康复护理效果的影响

Effect of postoperative rehabilitation nursing of orthopaedic protective stent for patients with tibial and fibular fracture

目的探讨骨科保护支架在胫腓骨折患者术后康复护理治疗中的作用。方法选择60例胫腓骨骨折术后患者，其中男性32例．女性28例：年龄19～70岁，平均年龄41．57岁。采用随机数字表法分为3组，即保护支架组、托马架组、软枕组．各20例。保护支架组男性10例，女性10例：托马架组男性12例，女性8例；软枕组男性10例，女性10例。分别在术后康复护理过程中使用新一代骨科保护支架、托马斯架及软枕对患肢进行抬高制动，比较3组患肢肿胀程度、疼痛与关节功能、稳定性、舒适度、局部压疮发生情况。结果患肢肿胀程度：术后2周时，保护支架组患者患肢I度肿胀（50．00％）、Ⅱ度肿胀（30．00％）明显高于软枕组I度肿胀（10．00％）、Ⅱ度肿胀（20．00％），保护支架组Ⅲ度肿胀（20．00％）明显低于软枕组（70．00％）：差异有统计学意义（P〈0．05）。疼痛与关节功能：术后2周时，保护支架组视觉模拟量表（VAS）评分明显低于托马架组、软枕组，关节活动度明显高于托马架组、软枕组，关节功能优良率（98.46％）明显高于软枕组（84．62％），差异有统计学意义（P〈0．05）。稳定性、舒适度、局部压疮：保护支架组高度与角度适合，患者舒适度明显高于托马架组、软枕组，局部压疮明显低于托马架组、软枕组．稳定性明显高于软枕组（P〈0．05）。结论骨科保护支架能充分满足胫腓骨’胃’折术后患肢抬高高度和角度的需要．稳定性好．能有效缓解肿胀及疼痛程度．提高舒适度．促进术后功能恢复．

Objective To study the effect of postoperative rehabilitation nursing of orthopaedic protective stent for patients with tibial and fibular fracture. Methods A total of 60 patients with tibia and fibula fracture were enrolled, which included 32 males and 28 females, aged 19 - 70 years old with mean age of 41.57 years old. All of them were randomly divided into 3 groups： protective stent group （n = 20, 10 males and 10 females, elevation and braking with orthopaedic stent）, Thomas- frame group（n = 20, 12 males and 8 females, elevation and braking with Thomas frame） and soft pillow group（n = 20, 10 males and 10 females, elevation and braking with soft pillow）. The limb swelling degree, pain and joint function, stability, comfortable de- gree and pressure ulcer in 3 groups were compared. Results The limb swelling degree I and Ⅱ after 2-week operation of protective stent group（ I 50 % and Ⅱ 30 %） were significant higher than that of soft pillow group（ I 10 % and 11 20 %）, but degree m （20 %） was significantly lower than that of soft pillow group（70 %）, and the difference was statistically significant（P 〈 0.05）. The pain and joint function after 2-week operation visual analog scale （VAS） score of protective stent group was significantly lower than that of Thomas-frame group and soft pillow group, but joint function was obviously higher than that of Thomas-frame group and soft pillow group, and the excellent rate of joint function （98.46 %） was significantly higher than that of soft pillow group（84.62 %）, the difference was statistically significant（P 〈 0.05）. The stability, comfortable degree and pres- sure ulcer of protective stent group showed proper height and angle, so comfortable degree was obviously higher than that of Thomas-frame group and soft pillow group. The pressure ulcer was significantly lower than that of Thonlas-franle group and soft pillow group, the stability was significantly higher than that of soft pillow group（P 〈 0.05）. Conclusion It is demonstrated that orthopaedic protective stent could sufficiently meet tibiofibula fracture limb elevation height and angle, which with good stability, relieve swelling pain degree and improve comfortable degree, so could promote functional recovery after surgery.