医护一体化护理对老年骨质疏松性股骨颈骨折术后下肢深静脉血栓影响

Effect of integrated nursing care on deep venous thrombosis of lower extremity after operation of senile osteoporotic femoral neck fracture

目的探讨医护一体化护理在预防老年骨质疏松性股骨颈骨折(FNF)患者术后下肢深静脉血栓(LEDVT)中的作用,为临床上采取有效护理措施提供参考。方法选取2018-01-15-2020-01-24中国人民解放军联勤保障部队第990医院信阳院区手术治疗的200例老年骨质疏松性FNF患者为研究对象。按照自愿及组间均衡可比的原则分为观察组和对照组,各100例。对照组患者实施常规护理,观察组患者实施医护一体化护理。比较2组术后LEDVT发生率、视觉模拟(VAS)、髋关节功能(HF)、护理满意度评分、血清肿瘤坏死因子-α(TNF-α)和白细胞介素-2(IL-2)水平。结果观察组患者术后LEDVT(χ^(2)=6.173,P=0.001)和其他并发症(χ^(2)=5.619,P=0.003)总发生率均低于对照组,差异有统计学意义。护理后,观察组VAS评分为(2.19±0.15)分,低于对照组的(4.72±0.31)分,t=5.237,P=0.003;HF评分以及护理满意度评分分别为(73.54±6.15)和(92.41±5.38)分,均高于对照组的(56.02±5.01)和(81.95±4.04)分,差异均有统计学意义,t值分别为6.739和5.671,P值分别为0.001和0.002。护理后,观察组血清TNF-α和IL-2水平分别为(13.81±1.74)U/L和(6.27±0.39)pg/mL,低于对照组的(21.49±2.37)U/L和(8.43±0.65)pg/mL,差异有统计学意义,t值分别为6.358和5.752,P值分别为0.001和0.002。结论医护一体化护理能够明显降低老年骨质疏松性FNF患者术后LEDVT的发生率,改善疗效。

Objective The purpose of this study was to explore the role of integrated nursing care in the prevention of deep vein thrombosis of lower extremity(LEDVT)in elderly patients with osteoporotic femoral neck fracture(FNF),to provide reference for effective nursing measures.Methods From January 15,2018 to January 24,2020 in Xinyang Hospital District,990 Hospital of Joint Logistics Support Force of PLA,a total of 200 elderly patients with osteoporotic FNF were selected as the research objects.According to the principle of voluntariness,they were divided into observation group and control group,with 100 cases in each group.The incidence of LEDVT,visual simulation(VAS),hip function(HF),nursing satisfaction score,serum tumor necrosis factor alpha(TNF-α)and interleukin-2(IL-2)levels were compared between the two groups.Results The total incidence of postoperative deep venous thrombosis(χ^(2)=6.173,P=0.001)and other complications(χ^(2)=5.619,P=0.003)in the observation group were lower than those in the control group,and the difference was statistically significant.After nursing,the VAS score of the observation group was(2.19±0.15),lower than that of the control group(4.72±0.31),t=5.237,P=0.003.HF score and nursing satisfaction score were(73.54±6.15)and(92.41±5.38)respectively,which were higher than those of the control group(56.02±5.01)and(81.95±4.04),and the differences were statistically significant,t values were 6.739 and 5.671,Pvalues were 0.001 and 0.002.After nursing,the serum levels of TNF-αand IL-2 in the study group were(13.81±1.74)U/L and(6.27±0.39)pg/ml respectively,which were lower than those of the control group(21.49±2.37)U/L and(8.43±0.65)pg/ml,with significant differences(t=6.358 and 5.752,P=0.001 and 0.002,respectively).Conclusion Integrated nursing care can significantly reduce the incidence of LEDVT in elderly patients with osteoporotic FNF and improve the curative effect.