快速康复外科理念在老年股骨粗隆间骨折PFNA内固定术围术期的应用效果及对患者睡眠质量的影响

Effect of Rapid Rehabilitation Surgery Concept on Perioperative PFNA Internal Fixationof Elderly Intertrochanteric Fracture and Its Influence on Sleep Quality of Patients

目的:探讨快速康复外科理念在老年股骨粗隆间骨折PFNA内固定术围术期的应用效果及对患者睡眠质量的影响。方法:选取2020年1月至2021年12月福建省宁德市古田县医院收治的老年股骨粗隆间骨折PFNA内固定术患者135例作为研究对象,按照随机数字表法随机分为对照组(n=67)和观察组(n=68)。对照组接受常规护理,观察组接受快速康复外科理念干预,比较2组患者围术期相关指标、睡眠质量、并发症发生率等。结果:观察组输血量、显性失血量均低于对照组,首次下地时间、住院时间均短于对照组,2组比较差异均有统计学意义(均P<0.05);手术前,2组患者匹兹堡睡眠质量指数(PSQI)评分、视觉模拟评分法(VAS)评分、Harris评分比较,差异均有统计学意义(均P>0.05),术后3 d时,观察组PSQI评分、VAS评分比对照组更低,Harris评分比对照组更高,2组比较差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,2组比较差异有统计学意义(P<0.05)。结论:老年股骨粗隆间骨折PFNA内固定术围术期接受快速康复外科理念干预,能改善疾病症状,降低并发症,利于术后恢复。

Objective:To investigate the effect of the concept of rapid rehabilitation surgery in the perioperative period of PFNA internal fixation for elderly intertrochanteric fractures and its influence on the sleep quality of patients.Methods:A total of 135 elderly patients with intertrochanteric fracture of femur who were treated with PFNA internal fixation from January 2020 to December 2021 were selected as the research objects.They were divided into control group(67 cases)and observation group(68 cases)by random number table method.The control group received routine nursing,and the observation group received the intervention of the concept of rapid rehabilitation surgery.Perioperative indicators,sleep quality,and the incidence of complications were compared between the two groups.Results:The amount of blood transfusion and overt blood loss in the observation group were lower than those in the control group,and the time of first landing and hospitalization in the observation group were shorter than those in the control group(P<0.05).Compared with Pittsburgh Sleep Quality Index(PSQI)score,Visual Analogue Scale(VAS)score and Harris score before operation(P>0.05),and 3 days after operation,PSQI score and VAS score in the observation group were lower,while Harris score was higher(P<0.05).The incidence of complications was lower in the observation group(P<0.05).Conclusion:Perioperative intervention with the concept of rapid rehabilitation surgery can improve disease symptoms,reduce complications and facilitate postoperative recovery in elderly patients with intertrochanteric femoral fracture treated with PFNA internal fixation.