老年髋部骨折术后实施延续性护理对患者远期功能恢复的影响

Effect of continuing nursing care on long-term functional recovery in elderly patients after hip fracture surgery

目的:研究术后实施延续性护理对提高老年髋部骨折患者远期功能恢复效果的价值。方法:纳入2013年7月至2015年7月于我院接受手术治疗的髋部骨折老年患者68例为对象,采用随机数字表法均分为2组各34例。所有患者院内均接受常规护理,对照组仅接受常规随访,观察组院外接受延续性护理,通过组建延续性护理服务小组、建立出院访视档案、组织成立延续护理俱乐部等措施,将系统、规范的院内护理延伸至院外。持续12个月后,对比2组康复锻炼依从性、生活质量、髋关节与膝关节功能评分、焦虑及抑郁评分、术后并发症情况。结果:观察组进行康复锻炼时,锻炼时间、锻炼动作严格遵嘱率明显高于对照组;干预12个月后观察组健康调查简表(MOS SF-36)量表各维度评分均明显高于对照组;干预3、6、12个月时Harris髋关节功能评分及HSS膝关节功能评分均明显高于对照组;干预12个月时观察组汉密尔顿焦虑及抑郁量表(HAMA及HAMD)得分均明显低于对照组。上述差异均有统计学意义(P<0.05)。观察组术后并发症发生率12.5%,明显低于对照组39.4%,差异有统计学意义(P<0.05)。结论:延续性护理有助于提升髋部骨折老年患者术后远期功能恢复效果,值得应用。

Objective： To study the value of continues nursing care on improving long-term functional recovery in elderly patients after hip fracture surgery. Methods： 68 cases of elderly patients with hip fracture who got operation in our hospital from July 2013 to July 2015 were included and divided into 2 groups with 34 cases in each by random number table. All patients were treated with routine nursing care in hospital, and the control group only received routine follow-up, while the observation group hospital was treated with continues nursing care. The continues nursing care was made to extend systematic and standardized hospital care to outside through the formation of continue nursing service team, establishment of discharge visit file, establishment of continuing nursing club and other measures. After 12 months, the compliance, quality of life, hip and knee function, anxiety and depression score, and postoperative complications were compared between the 2 groups. Results： In the observation group, the rate of strictly compliance with doctor’s advice on rehabilitation exercise time and action were significantly higher than those in the control group. 12 months after intervention, scores of all dimensions in MOS SF-36 in the observation group were significantly higher than those in the control group. 3, 6 and 12 months after intervention, the Harris and HSS scores in the observation group were significantly higher than those in the control group. 12 months after intervention, HAMA and HAMD scores in the observation group were significantly lower than those in the control group. All the above differences were statistically significant （P〈0.05）. The incidence rate of postoperative complications in the observation group was 12.5%, which was significantly lower than 39.4% in the control group, the difference was statistically significant （P〈0.05）. Conclusion： Continues nursing care is helpful to improve the long-term functional recovery of hip fracture in elderly patients, and it is worth to be applied.