快速康复外科理念联合临床路径护理模式在掌骨骨折患者中的应用

Application of Fast Track Surgery Concept Combined with Clinical Pathway Nursing Model in Patients with Metacarpal Fracture

目的:探讨快速康复外科理念(FTS)联合临床路径护理模式在掌骨骨折患者中的应用效果。方法:选取2020年10月-2021年10月甘肃省中医院收治的行手术治疗的掌骨骨折患者106例为研究对象,采用随机排列法将其分为对照组和试验组,每组53例。对照组围手术期给予常规护理,试验组围手术期给予FTS联合临床路径护理模式。比较术前1 d和术后3、5、7 d两组患者疼痛和患肢肿胀情况,分别于术后4、12周评价患者手指功能恢复情况,比较两组并发症发生情况。结果:两组术前1 d疼痛评分和患肢肿胀评分比较差异均无统计学意义(P>0.05);试验组术后3、5、7 d疼痛评分和患肢肿胀评分均低于对照组(P<0.05)。两组术前手部功能比较差异无统计学意义(P>0.05);试验组术后4、12周手部功能明显优于对照组(P<0.05)。试验组并发症发生率3.77%,低于对照组的16.98%(P<0.05)。结论:在掌骨骨折患者围手术期实施FTS联合临床路径护理模式不仅有助于缓解患者术后的疼痛和肿胀情况,还可以在减少并发症的同时促进手部功能恢复,更利于患者预后转归,临床应用效果显著。

Objective:To explore the application effect of fast track surgery concept(FTS)combined with clinical pathway nursing mode in patients with metacarpal fractures.Method:A total of 106 patients with metacarpal fracture who underwent surgical treatment in Gansu Hospital of Traditional Chinese Medicine from October 2020 to October 2021 were selected as the research objects,they were divided into control group and experimental group by random arrangement method,53 cases in each group.The control group was given routine nursing during the perioperative period,while the experimental group was given FTS combined with clinical pathway nursing mode during the perioperative period.The pain and limb swelling of the two groups were compared 1 day before operation and 3,5 and 7 days after operation.The recovery of finger function was evaluated at 4 and 12 weeks after operation,and the incidence of complications was compared between the two groups.Result:There were no significant differences in pain score and limb swelling score between the two groups at 1 day before operation(P>0.05).The pain score and limb swelling score of the experimental group were lower than those of the control group at 3,5 and 7 days after operation(P<0.05).There was no significant difference in preoperative hand function between the two groups(P>0.05).The hand function of the experimental group were significantly better than those of the control group at 4 and 12 weeks after operation(P<0.05).The complication rate of the experimental group was 3.77%,which was lower than 16.98%of the control group(P<0.05).Conclusion:The implementation of FTS combined with clinical pathway nursing mode in the perioperative period of patients with metacarpal fractures not only helps to relieve postoperative pain and swelling,but also promotes the recovery of hand function while reducing complications,which is more conducive to the prognosis of patients,the clinical application effect is remarkable.