全程无缝隙护理联合规范化疼痛管理用于开放性胫腓骨骨折的价值

Value of Whole--course Seamless Nursing Combined with Standardized Pain Management on Open Tibiofibular Fractures

探究全程无缝隙护理联合疼痛管理对开放性胫腓骨骨折患者疼痛和免疫状况的影响。方法:选取我院骨科于2019年5月-2020年3月收治的胫腓骨开放性骨折患者120例为研究对象,根据信封法将研究对象分为对照组58例,观察组62例。所有患者均行常规手术治疗,对照组给予常规护理及疼痛管理,观察组在围术期给予术前、术后全程无缝隙护理联合规范化疼痛管理。对比2组疼痛程度[视觉模拟评分法(VAS)]、免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、心理状态[焦虑自评量表(SAS)和抑郁自评量表(SDS)]评分及并发症发生情况。结果:干预3天时,2组VAS评分均较干预前降低(P<0.05),干预2周时VAS评分均较干预3天时降低(P<0.05),且观察组干预3天时及干预2周时VAS评分均较对照组低(P<0.05);干预后观察组患者免疫球蛋白IgA、IgG、IgM水平均高于对照组(P<0.05);干预后观察组患者SAS、SDS评分低于对照组患者(P<0.05);观察组的并发症发生率为3.23%,较对照组的13.79%低,差异有统计学意义(P<0.05)。结论:全程无缝隙护理联合规范化疼痛管理可明显改善胫腓骨开放性骨折患者术后疼痛,缓解焦虑、抑郁情绪,改善机体免疫状况,减少并发症发生率。

Objective:To explore the effect of whole-course seamless nursing combined with standardized pain management on the pain and immune status of patients with open tibiofibular fractures.Methods:120 patients with open tibiofibular fractures admitted to department of orthopedics of the hospital between May 2019 and March 2020 were selected as the study subjects.According to the envelope method,the study subjects were divided into control group(58 cases)and observation group(62 cases).All patients were treated with routine surgery,and the control group was given routine nursing and pain management,and the observation group was given preoperative and postop-erative seamless nursing combined with standardized pain management during perioperative period.The pain degree[Visual Analogue Scale(VAS)I,immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immuno-globulin M(IgM)],psychological status[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)J and occurrence of complications were compared between the two groups.Results:①At 3 days of interven-tion,the VAS scores of both groups were reduced compared with those before intervention(P<0.05),and the scores at 2 weeks of intervention were lower than those at 3 days of intervention(P<0.05).The VAS scores in ob-servation group at 3 days and 2 weeks of intervention were lower than those in control group(P<0.05).②The lev-els of immunoglobulins such as IgA,IgG and IgM after intervention were higher in observation group than those in control group(P<0.05).③After intervention,the scores of SAS and SDS of observation group were lower com-pared with those of control group(P<0.05).@The total incidence rate of complications in observation group was 3.23%,which was lower than 13.79%in control group(P<0.05).Conclusion:The implementation of whole-course seamless nursing combined with standardized pain management can improve the postoperative pain,relieve the anxiety and depression,improve body's immune status and reduce the incidence rates of complications of patients with open tibiofibular fractures.