基于CGA的针对性护理对行PFNA手术的高龄股骨粗隆间骨折患者功能康复及术后并发症的影响

Effect of targeted nursing based on CGA on the recovery and postoperative complications of elderly patients with intertrochanteric fracture in PFNA

目的:探讨基于老年综合评估(CGA)的针对性护理对行股骨近端髓内钉(PFNA)手术的高龄股骨粗隆间骨折患者功能康复及术后并发症的影响。方法:选取我院2016年3月~2017年9月收治的高龄股骨粗隆间骨折患者104例,将其随机等分为对照组和观察组,对照组采用常规护理,观察组采用基于CGA的针对性护理。比较两组股骨功能(Lysholm)评分、关节活动度(ROM)、疼痛程度(VAS)、步行功能(FAC)、运动功能评分(Fugl-Meyer)及术后并发症发生情况。结果:观察组患者护理后Lysholm评分、ROM高于对照组(P<0.05),VAS评分低于对照组(P<0.05),FAC评分高于对照组(P<0.05),协调能力、活动能力、反射能力、运动速度评分高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:基于CGA的针对性护理可改善高龄股骨粗隆间骨折患者的肢体功能,减少并发症的发生率,护理效果较好。

Objective: To explore the effect of targeted nursing based on comprehensive geriatric assessment( CGA) on the recovery and postoperative complications of elderly patients with intertrochanteric fracture in proximal femoral nail antirotation( PFNA). Methods: To select 104 cases of elderly patients with intertrochanteric fracture cured in our hospital from March 2016 to September 2017,and randomly divide them into control group and observation group. The control group was given routine nursing,while the observation group was given targeted nursing based on CGA. Compare score of thighbone function( Lysholm score),range of motion( ROM),pain degree( VAS),walk function( FAC),motor function( Fugl-Meyer) assessment and occurrence of postoperative complications. Results: After nursing,Lysholm score and ROM were higher in observation group than those in control group( P < 0.05),and the VAS score was lower than that in control group( P < 0. 05). Scores of FAC in observation group were higher than those in control group( P <0. 05). Scores of coordinate ability,mobility,reflectivity and velocity of movement in observation group were higher than those in control group( P < 0.05),while the occurrence of postoperative complications was lower than that in control group( P < 0. 05). Conclusion: The targeted nursing based on CGA could improve limb function of elderly patients with intertrochanteric fracture,reduce the occurrence of complications and achieve better nursing efficacy.