结构式护理联合心理疏导对颈椎骨折合并脊髓损伤患者心理状态及并发症的影响

Effect of structural nursing method combined with psychological guidance on the psychological status and complications of patients with cervical fracture combined with spinal cord injury

目的探讨结构式护理联合心理疏导对颈椎骨折合并脊髓损伤患者心理状态及并发症的影响。方法选取2019年6月—2020年4月许昌市某医院收治的80例颈椎骨折合并脊髓损伤患者为研究对象,采用随机数字表法分为研究组与对照组,各40例。对照组患者给予常规护理联合心理疏导,研究组患者在对照组护理基础上给予结构式护理,2组患者均持续护理4周。比较2组患者护理前后的脊椎功能[日本骨科学会脊椎功能量表(JOA)评分]、疼痛程度[视觉模拟量表(VAS)评分]及心理状态[心理弹性量表(CD-RISC)评分];比较2组患者并发症发生情况。结果护理前,2组患者JOA、VAS评分比较,差异均无统计学意义(P>0.05);护理后,研究组患者JOA评分高于护理前,且高于对照组,差异均有统计学意义(P<0.05);VAS评分低于护理前,且低于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者能力评价、消极情绪调节、对变化承受度、控制度及精神支撑评分比较,差异均无统计学意义(P>0.05);护理后,2组患者能力评价、消极情绪调节、对变化承受度、控制度及精神支撑评分均高于护理前,且研究组高于对照组,差异均有统计学意义(P<0.05)。研究组患者肺部感染、下肢深静脉血栓、骶尾部压疮、尿路感染发生率均低于对照组,差异均有统计学意义(P<0.05)。结论结构式护理联合心理疏导可有效改善颈椎骨折合并脊髓损伤患者的脊椎功能和心理状态,降低术后疼痛感,减少术后并发症,在临床上具有一定的推广应用价值。

Objective To explore the effect of structured care method combined with psychological guidance on the psychological state and complications of patients with cervical spine fracture combined with spinal cord injury.Methods Eighty patients with cervical spine fracture combined with spinal cord injury admitted to a hospital in Xuchang from June 2019 to April 2020 were selected as study subjects and divided into study group and control group using the random number table method,40 cases each.Patients in the control group were given conventional care combined with psychological guidance,and patients in the study group were given structured care based on the care of the control group,and both groups received continuous care for 4 weeks.The spinal function[Japanese Orthopaedic Association(JOA)score],pain level[visual analogue scale(VAS)score],and psychological status[Connor-Davidson Resilience Scale(CD-RISC)score]of the patients in the two groups were compared before and after care;the complications of the patients in the two groups were compared.Results Before care,there was no statistically significant difference between the JOA and VAS scores of patients in the 2 groups(P>0.05);after care,the JOA scores of patients in the study group were higher than those before care and higher than those in the control group,and the differences were statistically significant(P<0.05);the VAS scores were lower than those before care and lower than those in the control group,and the differences were statistically significant(P<0.05).Before nursing care,there was no statistically significant difference between the ability evaluation,negative emotion regulation,tolerance to change,control and spiritual support scores of the 2 groups;after nursing care,the ability evaluation,negative emotion regulation,tolerance to change,control and spiritual support scores of the 2 groups were higher than before nursing care,and the study group was higher than the control group in these regards,with statistically significant differences(P<0.05).The incidence of pulmonary infection,lower limb deep vein thrombosis,sacrococcygeal pressure sore and urinary tract infection in the study group was lower than that in the control group,and all differences were statistically significant(P<0.05).Conclusion Structural nursing combined with psychological guidance can effectively improve the spinal function and psychological status of patients with cervical fracture combined with spinal cord injury,reduce postoperative pain and postoperative complications,and is worthy of wider clinical application.