连续被动活动和功能锻炼应用于四肢骨折患者术后的效果分析

Continuous passive motion and functional exercise after limb fracture operation

目的观察分析四肢骨折术后连续被动活动(CPM)和功能锻炼及个体化优质护理干预的临床效果。方法选择2018年1月至2019年10月期间佛山市第五人民医院康复科及外三科收治的行切开复位内固定手术治疗的四肢骨折患者98例,随机分为两组,每组49例。对照组男26例、女23例,年龄(53.93±6.62)岁;观察组男27例、女22例,年龄(53.87±6.49)岁。对照组给予CPM及常规护理方法;观察组在对照组基础上给予功能锻炼及个体化优质护理干预。比较两组患者干预后疼痛程度、肢体运动功能、生活质量及护理满意度。结果观察组患者术后1 h、12 h、第1 d、第2 d、第3 d的视觉模拟评分法(VAS)评分均显著低于对照组(t=6.9852、8.6643、9.6957、10.5396、13.9147,均P<0.0001);两组干预后肢体运动功能评分较干预前均明显上升(均P<0.0001),观察组的肢体运动功能评分高于对照组[(94.68±5.32)分比(85.26±6.83)分](t=9.1306,P<0.0001);两组患者干预后生活质量评分均较干预前明显上升(均P<0.0001),观察组的生活质量评分高于对照组[(95.97±4.03)分比(86.17±5.47)分](t=10.2839,P<0.0001);观察组的总并发症发生率明显低于对照组[4.08%(2/49)比22.45%(11/49)](χ^(2)=7.1837,P<0.05);观察组的护理满意度显著高于对照组[97.96%(48/49)比79.59%(39/49)](χ^(2)=8.2947,P<0.05)。结论四肢骨折术后CPM和功能锻炼及个体化优质护理干预可以有效地缓解患者的疼痛程度,且显著地提高了肢体运动功能、生活质量及护理满意度,大大地降低了并发症发生率。

Objective To observe,evaluate,and analyze the clinical effect of continuous passive motion(CPM),functional exercise,and individualized high-quality nursing intervention after the operation of limb fracture.Methods A total of 98 patients with limb fracture treated with open reduction and internal fixation were selected from the Department of Rehabilitation and Third Department of Surgery of Foshan Fifth People's Hospital from January 2018 to October 2019,and were randomly divided into two groups,49 patients in each group.In the control group,there were 26 males and 23 females,with an age of(53.93±6.62)years old.In the observation group,there were 27 males and 22 females,with an age of(53.87±6.49)years old.The control group was treated with CPM and routine nursing,and the observation group was given functional exercise and individualized high-quality nursing intervention on the basis of the control group.The pain degree,limb motor function,quality of life(QOL),and nursing satisfaction were compared between the two groups after the nursing.Results The VAS scores of the observation group 1 h,12 h,1 d,2 d and 3 d after the surgery were significantly lower than those of the control group(t=6.9852,8.6643,9.6957,10.5396,13.9147;all P<0.0001).After the intervention,the scores of limb motor function in both groups were significantly higher than those before the intervention(both P<0.05),and the score of limb motor function in the observation group was significantly higher than that in the control group[(94.68±5.32)points vs.(85.26±6.83)points](t=9.1306,P<0.0001).After the intervention,the QOL scores of the two groups were significantly higher than those before the intervention(both P<0.05),and the QOL score of the observation group was significantly higher than that of the control group[(95.97±4.03)points vs.(86.17±5.47)points](t=10.2839,P<0.0001).The total complication rate of the observation group was significantly lower than that of the control group[4.08%(2/49)vs.22.45%(11/49)](χ^(2)=7.1837,P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group[97.96%(48/49)vs.79.59%(39/49)](χ^(2)=8.2947,P<0.05).Conclusions CPM,functional exercise,and individual high-quality nursing intervention can effectively relieve the pain of patients after limb fracture surgery,significantly improve limb motor function,QOL,and nursing satisfaction,and greatly reduce the incidence of complications.