不同护理方法在行髋关节置换术老年患者中的应用效果

Application effects of different nursing methods in elderly patients undergoing hip replacement

目的 分析术前心理干预结合术中精细化体温护理对行髋关节置换术老年患者手术相关指标的影响。方法 以2020年1月至2021年5月在贺州市人民医院行髋关节置换术的110例老年患者为研究对象,按照抽签法将其随机分为观察组、对照组,各55例。对照组患者在住院期间接受一般护理,观察组患者在住院期间基于对照组的护理方案给予术前心理干预结合术中精细化体温护理。比较2组患者的手术相关指标、术后恢复情况和凝血功能指标。结果 观察组的低体温发生率低于对照组,麻醉恢复时间和气管拔管时间均早于对照组(P均<0.05);观察组的手术时间短于对照组,但差异无统计学意义(P> 0.05)。观察组的首次下床时间明显早于对照组(P<0.05)。术前,比较2组的Harris评分,无统计学差异(P> 0.05);术后1个月、3个月和6个月,2组的上述评分均高于术前(P均<0.05),且观察组的Harris评分均高于同期对照组(P均<0.05)。术前,比较2组的凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原,均无统计学差异(P均> 0.05)。手术结束时,对照组的凝血酶原时间和活化部分凝血活酶时间均较术前延长,纤维蛋白原高于术前(P均<0.05);观察组的上述指标与术前相比,均未见统计学差异(P均>0.05);观察组的上述指标情况均优于对照组(P均<0.05)。结论 术前心理干预结合术中精细化体温护理可使行髋关节置换术老年患者的术后恢复速度加快,改善其凝血功能。

Objective To analyze the effect of preoperative psychological intervention combined with refined intraoperative body temperature nursing on the operation-related indicators of elderly patients undergoing hip replacement. Methods A total of 110 elderly patients who underwent hip replacement at Hezhou People’s Hospital from January 2020 to May 2021 were enrolled and divided into an observation group and a control group through drawing lots,with 55 cases in each group. The patients in the control group received general nursing during hospitalization,and the patients in the observation group received preoperative psychological intervention combined with refined intraoperative body temperature nursing based on the nursing method of the control group during hospitalization. The operation-related indicators,postoperative recovery,and coagulation function indicators were compared between the two groups. Results The incidence of hypothermia in the observation group was lower than that in the control group,and the time of anesthesia recovery and tracheal extubation was earlier than that in the control group(all P< 0. 05). The operation time of the observation group was shorter than that of the control group,but the difference was not statistically significant(P> 0. 05). The first time of getting out of bed in the observation group was significantly earlier than that in the control group(P< 0. 05). Before operation,there was no significant difference in Harris Hip Scores between the two groups(P> 0. 05). At 1, 3,and 6 months after operation,the Harris Hip Scores of the two groups were higher than those before operation(all P< 0. 05),and the Harris Hip Scores of the observation group were higher than those of the control group(all P< 0. 05). Before operation,there were no significant differences in the prothrombin time,activated partial thromboplastin time,and fibrinogen between the two groups(all P> 0. 05). At the end of operation,the prothrombin time and activated partial thromboplastin time in the control group were longer than those before operation,and the level of fibrinogen was higher than that before operation(all P< 0. 05). The above indicators in the observation group were not significantly different from those before operation(all P> 0. 05). The above indicators of the observation group were better than those of the control group(all P< 0. 05).Conclusion Preoperative psychological intervention combined with refined intraoperative body temperature nursing can accelerate the postoperative recovery of elderly patients undergoing hip replacement and improve their coagulation function.