延续性护理在脊柱骨折合并脊髓损伤术后患者中的应用效果

Application effects of continuous nursing in patients with spinal fractures combined with spinal cord injuries after surgeries

目的:观察延续性护理在脊柱骨折合并脊髓损伤术后患者中的应用效果。方法:选取84例脊柱骨折合并脊髓损伤术后患者为研究对象,按随机数字表法将其分为对照组和观察组各42例。对照组采用常规护理,观察组在对照组基础上采用延续性护理,比较两组护理前后功能独立性评定量表(FIM)评分、中文版脊髓独立性评定量表Ⅲ(SCIM-Ⅲ)评分、负性情绪[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表17(HAMD-17)]评分,以及并发症发生率。结果:护理后,观察组FIM评分和SCIM-Ⅲ自我照顾、呼吸和括约肌管理、移动能力评分及其总评分均高于对照组,差异有统计学意义(P<0.05);护理后,观察组HAMA、HAMD评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为9.52%(4/42),低于对照组的28.57%(12/42),差异有统计学意义(P<0.05)。结论:在常规护理基础上采用延续性护理可提高脊柱骨折合并脊髓损伤术后患者SCIM-Ⅲ评分和FIM评分,以及降低负性情绪评分和并发症发生率,效果优于单纯常规护理。

Objective: To observe application effects of continuous nursing in patients with spinal fractures combined with spinal cord injuries after surgeries. Methods: 84 patients with spinal fractures combined with spinal cord injuries after surgeries were selected as the research objects, and were divided into control group and observation group according to the random number table method, 42 cases in each group. The control group received routine nursing, while the observation group was given the continuous nursing on the basis of that of the control group. The scores of functional independence measure(FIM), Chinese version of spinal cord independence measure Ⅲ(SCIM-Ⅲ), the negative emotions [Hamilton anxiety scale(HAMA), Hamilton depression scale 17( HAMD-17)] score, and the incidence of complications were compared between the two groups before and after the nursing. Results: After the nursing, the FIM score as well the SCIM-Ⅲ self-care, breathing and sphincter management, mobility score and total score in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05).After the nursing, the HAMA and HAMD scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). Further, the incidence of complications in the observation group was 9.52%(4/42), which was lower than 28.57%(12/42) in the control group, and the difference was statistically significant(P<0.05). Conclusions: On the basis of the routine nursing, the continuous nursing can improve the SCIM-Ⅲ score and the FIM score and reduce the negative emotion score and the incidence of complications in the patients with spinal fractures complicated with spinal cord injuries after surgeries. Moreover, it is superior to single routine nursing.