模型讲解与视频宣教对老年胸腰椎骨质疏松骨折经皮椎体后凸成形术护理的影响

Effect of explain through model and education through video on elderly patients with thoracolumbar osteoporotic fracture treated by percutaneous kyphoplasty

目的 探讨脊柱模型讲解与视频宣教在老年胸腰椎骨质疏松压缩性骨折经皮椎体后凸成形术（PKP）护理中的应用效果。方法 前瞻性收集2013 年1 月至2015 年1 月沈阳军区总医院收治的符合纳入及排除标准的胸腰椎骨质疏松压缩性骨折老年患者共48 例。随机分为试验组（采用脊柱模型讲解与视频宣教，n=24）和对照组（采用常规围手术期宣教，n=24）。随访并比较两组患者焦虑自评量表（SAS）、抑郁自评量表（SDS）、疼痛视觉模拟评分（VAS）、患者依从性及满意度情况。结果 48 例患者均获得满意随访，随访时间为1 ～ 2 个月。末次随访时，试验组依从率（100%）及满意度（100%）均明显高于对照组（83.3%，83.3%），且差异均有统计学意义（χ2=4.364，P=0.037；χ2=4.286，P=0.038）。入院时两组患者SAS 和SDS 评分差异无统计学意义（P＞ 0.05），术后7 天及1 个月时对照组SAS 评分及SDS 评分均高于试验组，差异具有统计学意义（P ＜ 0.05）。与入院时相比，两组术后7 天及1 个月时的SAS 和SDS 评分均获得明显改善（P ＜0.05）。术后两组患者的VAS 评分均得到显著改善（P ＜ 0.05），且试验组低于对照组，差异具有统计学意义（t=-2.115，P=0.038）。结论 模型讲解与视频宣教可降低患者的焦虑、抑郁程度及疼痛症状，提高老年患者接受手术治疗的依从性及对护理工作的满意度。

Objective To discuss the efficacy of spinal model explaination and video missionon percutaneous kyphoplasty (PKP) in treatment of aged osteoporotic thoracolumbar compression fractures.Methods Prospective review was conducted for 48 elderly patients with osteoporotic thoracolumbarcompression fractures from January 2013 to January 2015. They were divided into two groups randomly,with 24 patients in each group. The patients in experimental group received spinal model explaination andvideo mission and those in control group received routine nursing care. Self-rating anxiety scale (SAS),self-rating depression scale (SDS), visual analogue scale (VAS), patients compliance and satisfaction werefollowed up and compared. Results All the 48 patients received 1-2 months followed up, at the lastfollow-up visit, the patients compliance (100%) and satisfaction (100%) of the experimental group weresignificant higher than the control group (83.3%, 83.3%; χ2=4.364, P=0.037; χ2=4.286, P=0.038). There wasno statistical significance of the SAS and SDS at admission, however, the scores of SAS and SDS in controlgroup were significant higher than that of experimental group (P<0.05) at 7 days and 1 month after surgery,and both groups had significant improvements compared with admission (P<0.05). There were significant differences in VAS before and after operation in the two groups (P<0.05), and VAS in observation groupwas lower than that in control group (t=-2.115, P=0.038). Conclusion Model explaination and videomission can relieve anxiety, depressed, and painful state, increase the patients compliance and nursing worksatisfaction in elderly patients with surgery.