老年下肢骨折患者术中建立规范化干预对患者凝血功能的影响

Value of standardized intervention on coagulation function in elderly patients with lower limb fracture

目的探讨老年下肢骨折患者术中建立规范化干预的价值及对患者凝血功能的影响。方法选取2020年1月至2021年6月收治的老年下肢骨折患者86例,按照随机法分为对照组和观察组,每组43例。对照组给予常规骨科护理,观察组采用规范化护理干预措施,比较2组的护理效果及凝血功能。结果观察组的平均住院时间、下床活动时间和骨折愈合时间均短于对照组(P<0.05)。观察组的自我管理能力评分高于对照组(P<0.05)。2组的汉密尔顿负性情绪自评量表(SAS和SDS)评分均低于干预前,且观察组低于对照组(P<0.05);观察组治疗依从性为90.70%高于对照组的72.09%(P<0.05);2组的纤维蛋白原(Fbg)水平降低,且观察组低于对照组,凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、凝血酶时间(TT)水平升高,且观察组高于对照组(P<0.05)。观察组术后并发症发生率为11.63%低于对照组的37.21%(P<0.05)。结论老年下肢骨折患者术中建立规范化护理干预措施,效果显著,能有效改善患者的凝血状态。

Objective To explore the value of standardized intervention on coagulation function in elderly patients with lower limb fracture.Methods From January 2020 to June 2021,eighty-six elderly patients with lower limb fracture were assigned to control group(n=43)and observation group(n=43),in which they received routine orthopedic nursing intervention and standardized nursing intervention,respectively.The aim was to compare nursing effect and coagulation function.Results After intervention,the observation group presented significantly shorter length of stay,ambulation time,fracture healing time,and significantly higher self-management ability score Compared with the control group(all P<0.05).The two groups showed significantly lower the Hamilton Anxiety Scale(HAMA)/the Self-Rating Anxiety Scale(SAS)scores and Hamilton Depression Scale(HAMD)/the Self-Rating Depression Scale(SDS)scores than those before intervention(P<0.05),and the observation group were more pronounced than in the control group(P<0.05).The treatment compliance in the observation group was better than that in the control group(90.70%vs 72.09%,P<0.05,respectively).Significantly decreased fibrinogen(Fbg),and significantly increased prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT)were detected in the two groups(all P<0.05),and the observation group was superior to the control group for Fbg,PT,aPTT,TT(all P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(11.63%vs 37.21%,P<0.05,respectively).Conclusion For elderly patients with lower limb fracture,standardized intervention during surgery has a significant effect,which can effectively improve coagulation status.