基于加速康复外科理念的护理模式结合耳穴埋豆在老年髋部骨折围手术期中的应用

Application of nursing model based on enhanced recovery after surgery concept combined with ear point embedding in the perioperative period of elderly hip fractures

目的探讨基于加速康复外科(ERAS)理念的护理模式结合耳穴埋豆对老年髋部骨折患者术后疼痛、负性情绪和睡眠质量的影响。方法选取2022年11月-2023年5月温州市中西医结合医院收治的200例老年髋部骨折手术患者,采用随机数字表法将其随机分为对照组(100例)和观察组(100例)。对照组实施基于ERAS理念的围手术期常规护理,观察组在此基础上给予耳穴埋豆干预。比较2组疼痛程度[视觉模拟评分法(VAS)]、疼痛介质[前列腺素E2(PGE2)、β-内啡肽(β-EP)]、焦虑情况[焦虑自评量表(SAS)]以及睡眠质量[匹兹堡睡眠质量指数(PSQI)]。结果观察组术后24 h、48 h和72 h VAS疼痛评分低于对照组(均P<0.05);观察组术后24 h、48 h和72 h PGE2和β-EP水平低于对照组(均P<0.05);观察组干预后SAS评分为(33.45±4.78)分,低于对照组的(38.90±6.09)分(t=7.040,P<0.05);观察组干预后PSQI评分为(9.10±1.23)分,低于对照组的(12.45±3.02)分(t=10.273,P<0.05)。结论基于ERAS理念的护理模式结合耳穴埋豆可有效缓解老年髋部骨折患者术后疼痛,消除焦虑情绪,提高睡眠质量,对患者早日康复有积极的意义。

Objective To investigate the effects of a medical care model based on the concept of enhanced recovery after surgery(ERAS)combined with ear point embedding on postoperative pain,negative emotions and sleep quality in elderly hip fracture patients.Methods Selected 200 elderly hip fracture patients who admitted to Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from November 2022 to May 2023,and divided into control group(100 cases)and observation group(100 cases)by digital table method,the control group received perioperative routine care based on ERAS concept,and the observation group received ear point embedding intervention on this basis.Pain severity[visual analogue scale(VAS)],pain mediators[prostaglandin E2(PGE2),beta-endorphin(β-EP)],anxiety status[self-rating anxiety scale(SAS)]and sleep quality[Pittsburgh sleep quality index(PSQI)]were compared between the two groups.Results The VAS scores of the observation group at 24 h,48 h and 72 h were lower than those of the control group(P<0.05);the levels of PGE2 andβ-EP at 24 h,48 h and 72 h after surgery were lower than those in the control group(P<0.05).The SAS score after surgery was(33.45±4.78)points,which was lower than that in the control group[(38.90±6.09)points,t=7.040,P<0.05].The PSQI score after the intervention was(9.10±1.23)points,which was lower than that in the control group[(12.45±3.02)points,t=10.273,P<0.05].Conclusion The care model based on the ERAS concept,combined with ear point embedding,can effectively reduce postoperative pain in elderly hip fracture patients,eliminate anxiety,improve sleep quality and have a positive impact on early patient recovery.