麻醉护理一体化管理模式对老年股骨颈骨折患者术后疼痛与心理状态的影响

The Impact of Integrated Anesthesia Nursing Management Model on Postoperative Pain and Psychological Status of Elderly Patients with Femoral Neck Fractures

目的:探讨与分析麻醉护理一体化管理模式对老年股骨颈骨折患者术后疼痛与心理状态的影响.方法:选择2021年2月—2023年1月我院收治的79例老年股骨颈骨折患者为研究对象,根据1∶1随机掷硬币原则将其分为一体化组和对照组.所有患者均给予丙泊酚和瑞芬太尼靶控输注喉罩静脉麻醉,对照组(n=39)在术后实施常规护理,一体化组(n=40)在对照组基础上增加麻醉护理一体化管理,2组护理观察时间均为7 d.比较2组的疼痛评分及心理状况改善情况.结果:一体化组的拔管时间、苏醒时间、麻醉恢复室滞留时间均短于对照组,组间差异有统计学意义(P<0.05).一体化组术后1 d、术后3 d、术后7 d的疼痛VAS评分均低于对照组,组间差异有统计学意义(P<0.05).一体化组术后下床活动时间、术后肛门排气时间、术后住院时间均短于对照组,组间差异有统计学意义(P<0.05).2组护理7 d后的SAS评分均低于护理前,且一体化组低于对照组,差异有统计学意义(P<0.05).一体化组不良反应发生率为5.00%,低于对照组的23.08%,差异有统计学意义(P<0.05).结论:麻醉护理一体化管理模式在老年股骨颈骨折患者术后的应用中,能促进麻醉苏醒,促进患者康复,还可提高镇痛效果和安全性,改善患者的不良心理状态.

Objective:Exploring and analyzing the impact of integrated anesthesia nursing management model on postoperative pain and psychological status of elderly patients with femoral neck fractures.Methods:Selecting 79 elderly patients with femoral neck fractures admitted to our hospital from February 2021 to January 2023 as the research subjects,Divide them into an integrated group and a control group based on the 1:1 random coin toss principle.All patients were given target controlled infusion of propofol and remifentanil for laryngeal mask intravenous anesthesia.The control group(n=39)received routine nursing care after surgery,while the integrated group(n=40)received integrated management of anesthesia and nursing care in addition to the control group.The nursing observation time for both groups was 7 days.Compare pain scores and psychological improvement between two groups.Results:The extubation time,awakening time,and anesthesia recovery room retention time of the integrated group were all shorter than those of the control group,and the difference was statistically significant(P<0.05).The VAS scores of pain in the integrated group were lower than those in the control group at 1 day,3 days,and 7 days after surgery,and the difference was statistically significant(P<0.05).The integrated group had shorter postoperative mobilization time,anal exhaust time,and hospital stay compared to the control group,the differences between groups were statistically significant(P<0.05).After 7 days of nursing,the SAS scores of both groups were lower than before nursing,and the integrated group was lower than the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the integrated group was 5.0%,lower than the 23.1%in the control group,the difference was statistically significant(P<0.05).Conclusion:The application of the integrated anesthesia nursing management model in the postoperative care of elderly patients with femoral neck fractures can promote anesthesia awakening,promote patient recovery,improve the analgesic effect and safety,and improve the patient's adverse psychological state.