基于风险评估策略下分层护理干预在老年髋关节置换术患者中的应用研究

Effect of a layered nursing intervention based on risk assessment strategies application in elderly patients with hip replacement

目的探讨基于风险评估策略下分层护理干预在老年髋关节置换术患者中的应用效果。方法选择2013年1月至2014年12月创伤骨科收治的行老年髋关节置换术的224例患者为研究对象，根据入院时间分为观察组和对照组各112例，观察组采用基于风险评估策略下分层护理干预，对照组采用常规护理方式，比较2组患者术后疼痛程度、髋关节功能、并发症、患者满意度。结果观察组术后24、48、72 h直观模拟标尺法（VAS）评分分别为（2.25 ± 0.35）、（2.01 ± 0.31）、（1.92 ± 0.23）分，对照组分别为（3.53 ± 0.51）、（2.84 ± 0.45）、（2.70 ± 0.35）分，2组比较差异有统计学意义（t=21.900、16.075、19.710，均P〈0.01）；术后3、12个月，观察组Harris髋关节指数评分分别为（71.32 ± 7.45）、（93.44 ± 9.65）分，明显高于对照组的（60.47 ± 6.65）、（83.75 ± 9.21）分，差异有统计学意义（t=11.498、7.688, P〈0.01）；观察组切口感染等并发症发生率为8.04%（9/112），明显低于对照组的20.54%（23/112），差异有统计学意义（χ2=7.146，P〈0.05）；观察组满意率97.32%（109/112），明显高于对照组78.57%（88/112），差异有统计学意义（χ2=18.572，P〈0.01）。 结论基于风险评估策略下分层护理干预有助于缓解老年髋关节置换术患者疼痛程度，改善髋关节功能，降低术后并发症，提高患者满意度。

ObjectiveTo explore a layered nursing intervention based on risk assessment strategies application effect in elderly patients with hip replacement.MethodsChosen during January 2013 to December 2014 rows of orthopaedic trauma treated 224 patients of senile hip replacement as the research objectto divide into observation group and control group 112 caseseach according to admission time.Observation group applied based on risk assessment strategy stratification nursing intervention, the control group used conventional care. Compared two groups of patients with postoperative pain degree, hip function, complications, and patient satisfaction.ResultsFor 24 h, 48 h, 72 h after the operation, Visual Analog Scale （VAS） scores of observation groupwere 2.25±0.35, 2.01±0.31, 1.92±0.23, which were significantly lower than 3.53±0.51, 2.84±0.45, 2.70±0.35 of the control group （t = 21.900, 16.075, 21.900, P〈 0.01）; 3 months and 12 months after the surgery, the index of the Harris hip score observation group was 71.32±7.45, 93.44±9.65, which were obviously higher than 60.47±6.65, 83.75±9.21 of control group （t = 11.498, 7.688, P 〈 0.01）; 8.04% （9/112） incidence of complications such as infection of incision, increase of observation group was obviously lower than 20.54% （23/112） of the control group （χ2= 7.146, P 〈 0.05） ; 97.32% （109/112） satisfaction was significantly higher than 78.57% （88/112） of the control group （χ2= 18.572, P 〈 0.05）.ConclusionsStratified nursing intervention based on risk assessment strategy can help to alleviate the degreeof pain, improve hip function, reduce postoperative complications and improve patient satisfaction.