快速康复外科理念应用于粗隆间骨折合并骨质疏松老年患者围手术期护理效果观察

Observation on the effect of perioperative nursing care of elderly patients with intertrochanteric fracture and osteoporosis using the concept of rapid rehabilitation surgery

目的:探讨快速康复外科理念应用于粗隆间骨折合并骨质疏松老年患者围手术期护理效果。方法:选取2018年5月至2020年10月收治的132例粗隆间骨折合并骨质疏松老年患者分为观察组和对照组,对照组采用常规护理,观察组给予快速康复外科理念下的护理措施,比较两组手术前后不同时间点NRS评分、术后不同时间点Kolcaba评分、住院时间及治疗费用、髋关节功能恢复情况、并发症发生情况。结果:手术前两组患者NRS评分对比差异无意义(P>0.05),术后6、24、48 h观察组患者NRS评分较对照组均显著下降(P<0.05),术后24 h、7 h、1周观察组Kolcaba评分较对照组均显著提高(P<0.05);观察组患者住院时间、治疗费用均低于对照组(P<0.05);观察组、对照组髋关节功能恢复优良率分别为89.39%、75.76%,观察组患者髋关节功能恢复优良率较对照组显著提高(P<0.05);观察组患者并发症发生率为4.55%,较对照组15.15%显著降低(P<0.05)。结论:快速康复外科理念应用于粗隆间骨折合并骨质疏松老年患者围手术期可缓解患者术后疼痛,提高患者舒适度,降低术后并发症,促进髋关节功能恢复,缩短住院时间,减少治疗费用,推广价值显著。

Objective:To explore and analyze the perioperative nursing effect of the rapid rehabilitation surgery concept in elderly patients with intertrochanteric fractures and osteoporosis.Methods:A total of 132 elderly patients with intertrochanteric fracture combined with osteoporosis who were treated from May 2018 to October 2020 were divided into experimental group and control group.The control group received conventional nursing,and the experimental group received nursing measures under the concept of rapid rehabilitation surgery.NRS scores,Kolcaba scores at different time points before and after surgery,length of hospital stay and treatment cost,hip joint functional recovery,and incidence of complications were compared between the two groups.Results:There was no significant difference in NRS scores between the two groups before surgery(P>0.05),and the NRS scores of the experimental group were significantly lower than those of the control group at 6,24,and 48 hours after surgery(P<0.05).The Kolcaba score of the observation group was significantly higher than that of the control group at 24 h,7h,and 1 week after operation(P<0.05).The hospital stay in the experimental group was significantly shorter than that of the control group,and the treatment cost was significantly lower than that of the control group(P<0.05),more economical.The excellent and good rates of hip joint function recovery in the experimental group and the control group were 89.39%and 75.76%,respectively.The good rate of hip joint function recovery in the experimental group was significantly higher than that in the control group(P<0.05).The incidence of complications in the experimental group was 4.55%,which was significantly lower than that in control group(15.15%,P<0.05).Conclusion:The rapid rehabilitation surgery concept applied to the perioperative period of elderly patients with intertrochanteric fractures and osteoporosis can relieve postoperative pain,improve body comfort,reduce postoperative complications,promote hip function recovery,shorten hospital stay,reduce treatment costs,and have significant promotion value.