基于加速康复外科理念的早期护理在老年骨质疏松性胸腰椎压缩性骨折患者中的应用

Application of early nursing based on the concept of enhanced recovery after surgery in elderly patients with osteoporotic thoracolumbar vertebral compression fractures

目的 考察基于加速康复外科理念的早期护理在行经皮椎体成形术的老年骨质疏松性胸腰椎压缩性骨折(OVCF)患者中的应用效果。方法 选取2021年1~12月于南方医科大学顺德医院行经皮椎体成形术的104例老年OVCF患者为研究对象。根据护理方式的差异分为对照组和观察组,每组52例。对照组给予常规护理模式,观察组给予基于加速康复外科理念的早期护理模式。比较2组在不同时间点的疼痛感、首次下床活动时间、住院时间、日常生活能力、生活质量和护理满意率。结果 2组在视觉模拟评分法(VAS)评分的比较上,手术后24 h<手术后12 h<手术后6 h<手术前1 d(P均<0.05);观察组在手术后各时间点的VAS评分均低于同期对照组(P均<0.05)。观察组的首次下床活动时间早于对照组,平均住院日短于对照组(P均<0.05)。2组在美国约翰普金斯医院跌倒危险评定量表评分的比较上,手术后7 d<手术前1 d<手术后1 d(P均<0.05),在Barthel指数和日常生活活动能力量表评分的比较上,手术后7 d>手术前1 d>手术后1 d(P均<0.05);观察组在手术后各时间点的上述各项评分均优于同期对照组(P均<0.05)。观察组的护理总满意率高于对照组(P<0.05)。结论 基于加速康复外科理念的早期护理能够有效改善行经皮椎体成形术的老年OVCF患者在术后的疼痛感,使其尽早下床活动,缩短平均住院日,降低跌倒风险,提高日常生活能力和护理满意率。

Objective To investigate the application effect of early nursing based on the concept of enhanced recovery after surgery in elderly patients with osteoporotic thoracolumbar vertebral compression fractures(OVCF)undergoing percutaneous vertebroplasty.Methods A total of 104 elderly OVCF patients who underwent percutaneous vertebroplasty at Shunde Hospital of Southern Medical University from January to December 2021 were selected as the study subjects.According to the differences in nursing methods,they were divided into a control group and an observation group,with 52 cases in each group.The control group received routine nursing intervention mode,while the observation group received early nursing mode based on the concept of enhanced recovery after surgery.Pain perception,first time of getting out of bed activity,hospitalization time,daily living ability,quality of life,and nursing satisfaction rate were compared between the two groups at different time points.Results In the comparison of Visual Analogue Scale(VAS)scores between the two groups,24 hours after surgery<12 hours after surgery<6 hours after surgery<1 day before surgery(all P<0.05).The VAS scores of the observation group at all postoperative time points were lower than those of the control group during the same period(all P<0.05).The first time of getting out of bed activity in the observation group was earlier than that in the control group,and the average hospital stay was shorter than that in the control group(both P<0.05).In the comparison of the score of Johns Hopkins Fall Risk Assessment Tool between the two groups,7 days after surgery<1 day before surgery<1 day after surgery(all P<0.05).In the comparison of Barthel index and Activities of Daily Living Scale scores,7 days after surgery>1 day before surgery>1 day after surgery(all P<0.05).The above scores of the observation group were better than those of the control group at all postoperative time points(all P<0.05).The total nursing satisfaction rate of the observation group was higher than that of the control group(P<0.05).Conclusion Early nursing based on the concept of enhanced recovery after surgery can effectively improve the postoperative pain perception of elderly OVCF patients undergoing percutaneous vertebroplasty,enable them to get out of bed as soon as possible,shorten the average hospital stay,reduce the risk of falls,and improve their daily living ability and nursing satisfaction rate.