漂浮膝伴同侧股骨颈及转子部骨折的护理体会

目的：总结漂浮膝伴同侧股骨颈及转子部骨折的护理体会。方法：对4例漂浮膝伴同侧股骨颈或转子部骨折行术前、术后的护理诊断、护理措施及疗效观察。结果：4例骨折均愈合，平均愈合时间6个月。膝关节活动度120°（90-120°）。髋部根据Brumback疗效评价标准^[2]，优3例，良1例。结论：漂浮膝伴同侧股骨颈或转子部骨折的术前护理诊断要准确全面、术后重点作好并发症的防范，采取合理的康复训练措施。

老年髋部股骨颈骨折患者THA术后认知和关节功能与营养状况相关性研究

目的探讨老年髋部股骨颈骨折髋关节置换术(THA)术后功能与营养状况相关性。方法回顾性分析2018年10月到2020年10月接治的113例人工全髋关节置换术老年髋部骨折患者,明确患者一般资料,借助MoCA认知功能量表、Sanders髋关节创伤后的功能评分、MNA营养评估量表对纳入患者营养及术后认知功能、关节功能及营养状况之间的相关性分析。结果113例患者中出现轻度认知障碍患者为54例,占样本的47.79%。未出现认知障碍患者59例,54例认知障碍患者的语言能力、记忆能力、注意力、执行能力、命名能力、定向能力、抽象思维能力等评分均低于未出现认知障碍患者(P<0.05)。50例患者出现关节功能障碍,63例未出现关节功能障碍,50例关节功能障碍患者的Sanders髋关节创伤后的功能评分高于对照组(P<0.05)。54例认知功能和50例关节功能障碍患者MNA营养评分低于功能正常患者(P<0.05),老年髋部股骨颈骨折THA术后认知功能(记忆能力、注意力、执行能力、命名能力、定向能力)、关节功能与营养状况存呈正相关(P<0.05)。结论老年髋部股骨颈骨折THA术患者认知功能越好,则关节功能恢复越好,营养状况越好。

品管圈在老年痴呆症患者股骨颈骨折护理中的应用

目的:评估品管圈在老年痴呆症患者股骨颈骨折护理中的应用价值。方法:将2011年1月-2014年12月杭州市富阳区第二人民医院骨科收治的160例股骨颈部骨折老年痴呆患者随机分为对照组(80例)和观察组(80例),对照组给予常规护理,观察组在常规护理基础上开展品管圈活动。评估观察组品管圈活动的目标达成率和进步率,比较两组患者的疼痛评分、舒适评分和对护理的满意度。结果:品管圈活动目标达成率和进步率分别为102.78%和69.23%;圈内成员综合素质评分有所提高;观察组患者的疼痛评分明显低于对照组,舒适评分明显高于对照组(P<0.05);治疗后观察组患者满意度(92.5%)明显高于对照组(66.3%),P<0.01;结论:品管圈活动有助于缓解股骨颈部骨折老年痴呆患者的疼痛,增强舒适度,提高患者的满意度。

Comprehensive treatment for old patients with hip fractures

Objective: To observe the effect of comprehensive treatment for hip fracture in old people. Methods: Three hundred and seventy two old patients with hip fractures were randomly divided into two groups, Group A and Group B. Cases in Group A were treated only by operations. Cases in Group B received comprehensive treatment. The Singh Indexes of both uninjured and injured femoral necks were used to judge the osteoporosis levels before operation and one year after the operation. The function of injured hip joints was evaluated one year postoperatively. Results: Complications occurred in 36.56 % of the cases in Group A and 5.91 % of Group B. One year postoperatively, the Singh Index degree distributions of both uninjured and injured femoral necks in Group A had no significant difference compared with those before the operation (P> 0.05 ). In Group B, there was significant difference between one year postoperatively and before operation, and the Singh Index one year after the operation showed better result than that before operation (P< 0.05 ). One year after operation, there was significant difference in the function of injured hip joints between Group A and Group B (P< 0.05 ). Conclusions: Hip fracture in old people should be treated comprehensively according to its internal characteristics, osteoporosis.