中医特色护理措施辅助保守疗法对老年肱骨外科颈骨折早期康复效果的影响

Effect of Chinese Medicine Characteristic Nursing Measures Assisted by Conservative Treatment on Early Rehabilitation of Fracture of Surgical Neck of Humerus in Senile

目的:观察中医特色护理措施辅助保守疗法对老年肱骨外科颈骨折患者早期康复效果的影响。方法:将86例老年肱骨外科颈骨折患者随机分为对照组42例和观察组44例。对照组予手法复位与小夹板外固定后,口服云南白药胶囊,并进行功能锻炼。观察组在对照组治疗基础上给予情志护理、饮食护理、耳穴压豆和艾灸,连续治疗、观察10天,并进行3周随访。于治疗前、治疗5天和10天后评价患处疼痛和肿胀程度,于随访结束时进行Neer评分,出院时由患者评价护理满意度,记录2组患者配合功能锻炼和遵医行为的情况。结果:治疗5天和10天后,2组疼痛和肿胀程度评分均较治疗前降低(P <0.01),观察组的疼痛和肿胀程度评分均低于对照组(P <0.01)。随访3周结束时,观察组Neer总分及疼痛、功能情况和活动范围3个维度评分均高于对照组(P <0.01)。观察组护理满意度、功能锻炼配合情况和遵医行为均优于对照组(P <0.05)。结论:中医特色护理措施有利于减轻肱骨外科颈骨折患者早期的肿痛,提高患者的功能锻炼配合情况、遵医行为和护理满意度,促进康复。

Objective:To observe the effect of Chinese medicine characteristic nursing measures assisted by conservative treatment on early rehabilitation of fracture of surgical neck of humerus in senile. Methods: A total of 86 cases of senile patients with fracture of surgical neck of humerus were randomly divided into the control group and the observation group,42 and 44 cases in each group respectively. The control group received oral administration of Yunnan Baiyao capsules after manual reduction and small splint external fixation, and took functional exercises. The observation group was additionally given emotion nursing, dietary nursing, auricular acupoint pressing with beans and moxibustion based on the treatment of the control group. Both groups were treated and observed for ten days,and received three-week follow-up. The scores of pain and swelling were evaluated before treatment,five days and ten days after treatment respectively;the scores of Neer were evaluated at the end of the follow-up;the nursing satisfaction was evaluated by patients at discharge;the cooperation of functional exercises and compliance behavior in the two groups were recorded. Results: After five-day and ten-day treatment,the scores of pain and swelling in the two groups were decreased when compared with those before treatment respectively(P < 0.01),and the above scores in the observation group were lower than those in the control group(P < 0.01). At the end of three-week follow-up,the total scores of Neer as well as the scores of pain,function and the range of motion in the observation group were higher than those in the control group(P < 0.01). The nursing satisfaction,cooperation of functional exercises and compliance behavior in the observation group were better than those in the control group(P < 0.05). Conclusion:Chinese medicine characteristic nursing measures are beneficial to alleviating the swelling and pain of patients with fracture of surgical neck of humerus in the early stage, improving the cooperation of functional exercises, compliance behavior and nursing satisfaction of patients as well as promoting rehabilitation.