老年骨质疏松髋部骨折48 h手术绿色通道病房及相关护理

Green channel ward for 48-hour operation of elderly osteoporotic hip fractures and related nursing

目的探讨老年骨质疏松髋部骨折48小时手术绿色通道病房建立及相关护理的要点及临床疗效。方法回顾性分析2019年1月-2020年1月本院老年骨质疏松髋部骨折48 h手术绿色通道病房收治的62例老年骨质疏松髋部骨折患者资料,男21例,女41例;年龄为63~94岁,平均81.2岁;股骨颈骨折47例,股骨转子间骨折15例。所有患者均按我院老年骨质疏松髋部骨折48小时手术绿色通道收治流程治疗;进行针对性的术前、术后护理,辅导患者进行功能锻炼及出院指导,对患者进行随访。根据髋关节功能评分标准(Harris评分)评价患者术后髋关节功能恢复情况及手术效果优良率,分析患者平均住院时间、术后死亡率及术后并发症发生率。结果62例患者经过针对性的护理后均安全度过围手术期,住院时间平均为5.4 d(3~12 d)。Harris评分为(84.4±59.38)分,手术效果优良率为93.5%,术后共有2例患者发生不同程度的并发症,经对症处理后均好转,无一人发生死亡。结论老年骨质疏松髋部骨折48 h手术绿色通道病房配合针对性的优质护理,能使患者早期获得功能锻炼,缩短老年骨质疏松髋部骨折患者的住院时间,降低其住院期间死亡率和术后并发症发生率。

Objective To explore the key points and clinical effect of green channel ward establishment and related nursing in 48hours operation of senile osteoporotic hip fracture.Methods Retrospective analysis was performed on the data of 62 elderly patients with osteoporosis and hip fracture admitted to the green channel ward for 48-hour operation from January 2019 to January 2020,including 21males and 41 females.The age ranged from 63 to 94,with an average age of 81.2.There were 47 cases of femoral neck fracture and 15cases of intertrochanteric fracture.All patients were treated according to the green channel of 48-hour operation for senile osteoporosis hip fracture in our hospital.All the patients were given targeted preoperative and postoperative care,coached for functional exercise,and guided for discharge,followed up the patients.The postoperative hip function recovery and the rate of excellent and good surgical results were evaluated according to the Harris hip function Score,and the average length of stay,postoperative mortality and postoperative complications were analyzed.Results All the 62 patients passed the perioperative period safely after targeted nursing,and the average length of hospital stay was 5.4 d(3-12 d).Harris score was(84.4±59.38)points,and the rate of excellent and good surgical results was93.5%.There were 2 patients with different degrees of postoperative complications,which were all improved after symptomatic treatment,and no one died.Conclusion 48-hour operation for senile osteoporotic hip fracture Green channel ward combined with targeted high-quality nursing can enable patients to obtain early functional exercise,shorten the length of hospital stay for senile osteoporotic hip fracture patients,and reduce the incidence of in-hospital mortality and postoperative complications.