早期预警性护理干预应用于高龄人工全髋关节置换手术配合中对患者应激反应和术后并发症的影响

Effects of Early Warning Nursing Intervention on Stress Response and Postoperative Complications in Elderly Patients Undergoing Total hip Replacement Surgery

目的：探讨早期预警性护理干预应用于高龄人工全髋关节置换手术配合中对患者应激反应和术后并发症的影响.方法：从2016年1月～2018年1月于我院行人工全髋关节置换手术的患者中,抽选75名高龄患者作为此次研究对象,按照随机排列法将其分为对照组（n=37）与观察组（n=38）,对照组手术期间给予常规护理配合,观察组则给予早期预警性护理干预,对比2组患者手术期间生理应激及心理应激反应变化、术后并发症发生率,通过远期随访调查2组患者髋关节功能恢复情况.结果：2组患者麻醉开始前肾上腺素、去甲肾上腺素以及多巴胺水平对比无统计学意义（P〉0.05）,术毕即刻,2组上述各指标较麻醉开始前均有明显升高,术后24小时,观察组肾上腺素以及多巴胺水平均明显低于对照组,差异对比有意义（P〈0.05）;护理前2组患者焦虑、抑郁程度对比均无统计学意义（P〉0.05）,护理后观察组焦虑、抑郁评分明显低于对照组,差异对比有意义（P〈0.05）;观察组治疗期间并发症发生率稍低于对照组,差异对比有意义（P〈0.05）;远期随访发现,观察组髋关节功能恢复总优良率明显优于对照组,差异对比有统计学意义（P〈0.05）.结论：早期预警性护理干预应用于高龄人工全髋关节置换手术配合中,可有效降低患者术中生理、心理应激,同时有助于降低术后并发症,对促进患者早日康复具有重要的临床意义.

Objective： To explore the effect of early warning nursing intervention on stress response and postoperative complications in elderly patients undergoing total hip arthroplasty. Methods： From January 2016 to January 2018,75 elderly patients were selected as the subjects of total hip replacement in our hospital. They were divided into the control group（ n = 37） and the observation group（ n = 38 ） according to the random arrangement method. The control group was given routine nursing during the operation, and the observation group was given early warning nursing intervention, compared the two groups of patients during the operation of physiological stress and psycho- logical stress response changes, postoperative complications, through a long - term follow - up surveying two groups of patients with hip function recovery. Results： Before the anesthesia began, the levels of adrenalin, norepinephrine and dopamine were not statistically sig- nificant in the two groups （P 〉0.05）. The above indexes were significandy higher in the two groups than before the anaesthesia, and the levels of epinephrine and dopamine in the observation group were significantly lower than those in the control group after the operation, and the difference was compared between the two groups（ P 〈 0.05 ） ; Before nursing, there was no significant difference in the degree of anxie- ty and depression between the two groups （ P 〉 0.05 ）. After nursing, the scores of anxiety and depression in the observation group were significantly lower than those in the control group, and the difference was significant（ P 〈 0.05 ）. The incidence of complications in the observation group was slightly lower than that in the control group, and the difference was significant（ P 〈 0.05 ）. Long term follow - up showed that the total excellent and good rate of hip function recovery in the observation group was significantly better than that in the control group, and the difference was statistically significant（ P 〈 0.05 ）. Conclusion： Early warning nursing intervention is used in the operation of elderly artificial total hip replacement, which can effectively reduce the physiological and psychological stress of the patients, and also help to reduce postoperative complications. It has important clinical significance to promote the early recovery of the patients.