多元合作术后加速康复护理干预在骨盆骨折行骶髂固定患者围术期中的应用

Multivariate ERAS nursing intervention for patients with Tile C pelvic fractures undergoing Legency cMAS sacroiliac fixation

目的:探讨多元合作术后加速康复(ERAS)护理干预在Tile C型骨盆骨折行Legency c MAS骶髂固定围术期中的应用价值。方法:前瞻性选取2012年1月至2017年12月本院骨科收治的81例Tile C型骨盆骨折患者,采用随机数字表法将患者分为研究组(41例)和对照组(40例)。研究组采用多元合作ERAS围术期护理干预,对照组采用常规围术期护理干预,对比两组患者手术和康复相关指标、住院费用、围术期并发症、护理满意度的差异,并应用视觉模拟疼痛评估法(VAS)、MATTA评分、MAJEED评分、GIBBONS评分评价两组患者围术期疼痛程度、复位情况、临床功能恢复情况、神经功能受损恢复情况。结果:研究组首次下床活动时间、住院时间、住院费用均短于或低于对照组[(4.53±1.24) d vs(6.25±2.39) d、(9.15±2.69) d vs(15.02±3.57) d、(3.64±1.17)万元vs(5.19±2.05)万元,均P<0.05]。研究组术后VAS评分在术后24 h、48 h、72 h、7 d均低于对照组(均P<0.05)。研究组MATTA评分、MAJEED评分优良率高于对照组(90.24%vs 75.00%、85.36%vs 70.00%,均P<0.05),GIBBONS评分Ⅰ-Ⅱ级比例高于对照组(75.61%vs57.50%,P<0.05)。研究组围术期并发症发生率低于对照组(5.00%vs 32.50%,P<0.05),护理满意度高于对照组(100.00%vs 85.00%,P<0.05)。结论:多元合作ERAS护理干预可明显减轻行Legency c MAS骶髂固定术Tile C型骨盆骨折患者术后疼痛程度,促进骨折复位、功能恢复,显著缩短住院时间,降低住院费用和并发症发生率,患者满意度高。

Objective: To explore the application value of multimodal cooperative enhanced recovery after surgory(ERAS) nursing intervention in Tile C type pelvic fracture undergoing Legency c MAS sacroiliac fixation.Methods: 81 patients with Tile C-type pelvic fractures admitted to our department were prospectively selected from January 2012 to December 2017.The patients were divided into two groups by random number table.The study group(41 cases) underwent multi-operative ERAS perioperative period.In the nursing intervention,while the control group(40 cases) used routine perioperative nursing intervention.The differences in surgical andrehabilitation related indicators,hospitalization costs,perioperative complications,and nursing satisfaction between the two groups were compared.Using visual analogue pain assessment(VAS),MATTA score,MAJEED score,and GIBBONS score, the perioperative pain level, reduction, clinical function recovery, and recovery of neurological impairment in the two groups were evaluated.Results: The time of first off bed activity,hospitalization time,and hospitalization cost of the study group were lower than those of the control group [(4.53±1.24) d vs(6.25±2.39) d,(9.15±2.69) d vs(15.02±3.57) d,(3.64±1.17) million vs(5.19±2.05) million,P <0.05].The postoperative VAS scores of the study group were lower than that of the control group at 24 h,48 h,72 h and 7 d after operation,and the difference was statistically significant(P<0.05).The excellent rate of MATTA score and MAJEED score in the study group was higher than that in the control group(90.24% vs75.00%,85.36% vs 70.00%,P<0.05),and the GIBBONS score was higher than that in the control group(75.61% vs 57.50%,P<0.05).The perioperative complication rate of the study group was lower than that of the control group(5.00% vs 32.50%,P<0.05),and the nursing satisfaction was higher than that in the control group(100.00% vs 85.00%,P<0.05).Conclusion: Multiple cooperative ERAS nursing intervention can significantly reduce the degree of postoperative pain in patients with Legency c MAS sacroiliac fixation of Tile C type pelvic fractures, promote fracture reduction and functional recovery, shorten hospitalization time, reduce hospitalization costs and complications,and have high patient satisfaction.