针对性护理对老年股骨转子间骨折患者髋关节置换术疗效的影响

Efficacy of targeted nursing on senile patients with total hip arthroplasty after introchanteric femoral fracture

目的观察针对性护理对老年股骨转子间骨折患者髋关节置换术疗效的影响,总结护理经验。方法入选2013年1月至2014年12月间治疗的120例老年股骨转子间骨折患者作为研究对象,并分为观察组和对照组,每组各60例患者,所有患者均知情同意,并签署知情同意书。对照组行髋关节置换术后采用常规护理,观察组术后采用针对性护理干预。比较两组术后1年髋关节Harris评分改善情况和术后并发症发生情况,以评价针对性护理干预的效果。结果观察组患者共55例(91.67%)完成研究,对照组患者共58例(96.67%)完成研究;观察组术后1年Harris疼痛评分(42.12±0.97)、步态评分(30.25±1.17)、日常生活评分(12.29±0.78)、体征表现评分(0.24±0.13)、查体结果评分(4.22±0.30)和总分(89.12±5.15)均明显优于对照组(35.59±4.91、26.79±3.25、11.51±1.74、0.89±0.45、3.85±0.45、78.63±10.75)(P<0.05),2组患者阳性体征表现发生率差异无统计学意义(P>0.05);观察组总体并发症发生率(9.09%)显著低于对照组(44.83%)(P<0.05)。结论采用针对性护理对老年IFF行THA患者进行治疗可显著改善髋关节功能,降低并发症。

Objective To investigate the effects of targeted nursing on senile patients with total hip arthroplasty （ THA） after introchanteric femoral fracture （ IFF） , and also to sum up the obtained nursing experience .Methods One hundred and twenty senile patients with IFF admitted into the hospital for the treatment of THA from January 2013 to December 2014 were enrolled for the study and were randomly divided into the observation group and the control group , each consisting of 60 patients.The control group was given conventional nursing after THA , while the observation group was supplemented with targeted nursing intervention .One year after surger-y, postoperative Harris hip scores and rates of complication were compared between the 2 groups, and then, efficacy of different nursing modes was evaluated.Results Fifty-five patients in the observation group （91.67%） completed the study, while 58 patients in the control group （96.67%） completed the study.One year after surgery, Harris pain scores of the observation group were （42.12 ± 0.97）, gait scores were （30.25 ±1.17）, daily life scores were （12.29 ±0.78）, symptom signs scores were （0.24 ±0.13）, physical examination scores were （4.22 ±0.30）, and total Harris scores were （89.12 ±5.15）, which were all significantly superior to those of the control group（35.59 ±4.91, 26.79 ±3.25, 11.51 ±1.74, 0.89 ±0.45, 3.85 ±0.45, 78.63 ±10.75） （P〈0.05）.There was no statistical difference in the manifestations of positive symptom signs , when comparisons were made between the patients of the 2 groups（P〉0.05）.The incidence of total complication of the observation group （9.09%） was significantly lower than that of the con-trol group （44.83%）.Conclusion Targeted nursing in the care of the senile patients who underwent THA due to IFF could signifi-cantly improve the hip joint function and reduce complications .