早期活动方案在高龄股骨转子间骨折患者护理康复中的应用研究

Study on application of early activity program in nursing rehabilitation of elderly patients with femoral intertrochanteric fracture

目的探讨早期活动方案对高龄股骨转子间骨折患者护理康复的应用效果。方法选取2018年9月至2020年9月住院治疗的高龄股骨转子间骨折患者84例,随机分为试验组和对照组,各42例。试验组按早期活动方案进行护理康复,对照组按常规活动方案进行护理康复,两组均随访6~12个月,比较两组病例下地活动时间、术后第3天可行走的距离(助行器辅助下)、住院时间、出院时的日常生活能力、术后3个月及6个月Harris髋关节功能评分。结果所有病例平均获得(8.2±1.7)个月的随访,试验组首次下地活动时间、术后第3天可行走的距离、住院时间、出院时ADL评分分别为(1.6±0.7)d、(41.4±25.8)m、(7.9±1.5)d、(76.1±6.8)分,与对照组的(2.4±0.9)d、(13.5±11.2)m、(10.7±2.4)d、(68.9±5.9)分比较,差异有统计学意义(P<0.01);试验组和对照组出院时的护理满意度分别为97.6%、81.0%,差异有统计学意义(P<0.05);术后3个月,试验组和对照组髋关节功能Harris评分优良率分别为66.7%、45.2%,差异有统计学意义(P<0.05);术后6个月,试验组和对照组髋关节功能Harris评分优良率分别为88.1%、81.0%,差异无统计学意义(P>0.05)。结论有效的康复方案是决定高龄股骨转子间骨折患者术后髋关节功能恢复的关键,而早期活动方案有助于高龄股骨转子间骨折患者早期功能的恢复,提高患者的护理满意度和早期生活质量。

Objective To explore the effect of early activity program on nursing rehabilitation of elderly patients with femoral intertrochanteric fracture.Methods 84 elderly patients with femoral intertrochanteric fracture who were hospitalized from September 2018 to September 2020 were randomly divided into experimental group and control group,with 42 cases in each group.The experimental group received nursing rehabilitation according to early activity plan,while the control group received nursing rehabilitation according to routine activity plan.Both groups were followed up for 6-12 months.And then,the start time of ground movement,walking distance on the third day after operation(assisted by walking aid),length of hospital stay,ability of daily living at discharge,Harris hip function score of 3 and 6 months after operation were compared between the two groups.Results All patients were followed up for(8.2±1.7)months on average.The start time of ground movement,walking distance on the third day after operation,length of hospital stay,ability of daily living(ADL)at discharge in the experimental group were(1.6±0.7)d,(41.4±25.8)m,(7.9±1.5)d and(76.1±6.8)points,respectively,while compared with those of the control group([2.4±0.9]d,[13.5±11.2]m,[10.7±2.4]d,[68.9±5.9]points),difference was statistically significant(P<0.01).The nursing satisfaction of the experimental group and the control group at discharge were 97.6%and 81.0%,respectively,and difference was statistically significant(P<0.05).3 months after operation,the excellent and good rate of Harris score of hip joint function in the experimental group and the control group were 66.7%and 45.2%,respectively,and difference was statistically significant(P<0.05).6 months after operation,the excellent and good rate of Harris score of hip joint function in the experimental group and the control group were 88.1%and 81.0%,respectively,and difference was not statistically significant(P>0.05).Conclusion Effective rehabilitation program is the key to determine the functional recovery of hip joint in elderly patients with femoral intertrochanteric fracture,and early activity program is helpful to the early functional recovery of the patients,and improve the nursing satisfaction and early quality of life of them.