多学科疼痛管理模式在老年髋部骨折患者中的应用效果

Application Effect of Multidisciplinary Pain Management Model in Elderly Patients with Hip Fractures

目的:探讨多学科疼痛管理模式在老年髋部骨折患者中的应用效果。方法:选取2020年1月—2021年12月惠州市中心人民医院收治的160例老年髋部骨折患者。根据简单随机化法将其分为对照组(n=80)和观察组(n=80)。两组均进行髋关节置换术或闭合复位内固定术。对照组给予传统疼痛管理模式,观察组给予多学科疼痛管理模式。比较两组术前、术后1 d及7 d疼痛程度,康复情况,术前及术后12个月髋关节功能,并发症及满意度。结果:术后1 d、7 d,两组视觉模拟评分法(VAS)评分较术前低,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组术后功能锻炼开始时间早于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。术后12个月,两组畸形、关节活动度、疼痛、功能评分均较术前升高,观察组畸形、关节活动度、疼痛、功能评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率(3.75%)低于对照组(12.50%),差异有统计学意义(P<0.05)。观察组总满意度为95.00%,高于对照组的83.75%,差异有统计学意义(P<0.05)。结论:多学科疼痛管理模式应用于老年髋部骨折患者中可减轻疼痛感,恢复髋关节功能,促进康复,减少术后并发症发生的同时提高满意度。

Objective:To investigate the application effect of multidisciplinary pain management model in elderly patients with hip fractures.Method:A total of 160 elderly patients with hip fracture admitted to Central People's Hospital of Huizhou City from January 2020 to December 2021 were selected.They were divided into control group(n=80)and observation group(n=80)according to simple randomization method.Both groups underwent hip joint replacement operation or closed reduction internal fixation operation.The control group was given traditional pain management mode,and the observation group was given multidisciplinary pain management mode.The degree of pain before and 1 d and 7 d after operation,rehabilitation condition,hip joint function before and 12 months after operation,complications and satisfaction were compared between the two groups.Result:On the 1 d and 7 d after operation,the visual analogue scale(VAS)scores of the two groups were lower than those before operation,and the VAS scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The start time of postoperative functional exercise of observation group was earlier than that in the control group,and the hospital stay time was shorter than that in the control group,the differences were statistically significant(P<0.05).At 12 months after operation,the scores of deformity,joint range of motion,pain,and function in both groups increased compared to before operation,the observation group had higher scores of deformity,joint range of motion,pain,and function than those in the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group(3.75%)was lower than that in the control group(12.50%),the difference was statistically significant(P<0.05).The total satisfaction rate of the observation group was 95.00%,which was higher than 83.75%of the control group,the difference was statistically significant(P<0.05).Conclusion:The application of multidisciplinary pain management model in elderly patients with hip fracture can reduce pain,restore hip joint function,promote rehabilitation,reduce postoperative complications and improve satisfaction.