风险评估策略下的分层干预在髋关节置换术后患者护理中的应用

Application of stratified intervention under risk assessment strategy in nursing of patients after hip arthroplasty

目的探讨风险评估策略下分层干预对髋关节置换术后患者护理效果的影响。方法选取2020年4月至2022年1月南京市第一医院骨科200例行髋关节置换术的股骨头坏死患者,利用计算机生成的随机数字分成观察组与对照组,每组100例。对照组采取常规护理干预,观察组采取常规护理联合风险评估策略下的分层干预,两组均干预至出院时。比较两组出院时疼痛程度[采用疼痛数字评分(NRS)评估],干预前、出院时髋关节功能(使用Harris髋关节功能评分量表评估),日常生活活动能力[使用改良Barthel指数(MBI)评估]及术后并发症情况。结果观察组出院时疼痛程度低于对照组,差异有统计学意义(P<0.05)。出院时,两组Harris髋关节功能、MBI评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论风险评估策略下的分层干预可减轻髋关节置换术后患者疼痛程度,加快患者髋关节功能的恢复,增强患者日常生活活动能力,且术后并发症较少。

Objective To investigate the impact of a stratified intervention under a risk assessment strategy on the outcome of patient care after hip arthroplasty.Methods Two hundred patients with femoral head necrosis carried hip arthroplasty in the Department of Orthopedics,Nanjing First Hospital from April 2020 to January 2022 were selected and divided into observation and control groups using computer-generated random numbers,with 100 cases in each group.The control group adopted conventional nursing interventions while the observation group adopted stratified interventions under conventional nursing combined with risk assessment strategies,and both groups were intervened until the time of discharge.The degree of pain at discharge(assessed using the numerical pain score[NRS]),hip function(assessed using the Harris hip function rating scale)before the intervention and at discharge,activities of daily living(assessed using the modified Barthel index[MBI]),and postoperative complications were compared between the two groups.Results The pain level at discharge was lower in the observation group than that in the control group,and the difference was statistically significant(P<0.05).At discharge,the Harris hip function and MBI scores of both groups were higher than before the intervention,while those in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The overall incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Stratified interventions under the risk assessment strategy can reduce the degree of pain,accelerate the recovery of hip function,and enhance patients'activities of daily living after hip arthroplasty with fewer postoperative complications.