康志敏 孙启才

[摘要] 目的 探讨综合护理干预措施在老年股骨颈骨折人工髋关节置换术（THA）护理中的临床应用效果，为临床护理干预提供一定的参考价值。 方法 将46例行THA的股骨颈骨折患者随机分为对照组（n=23）和观察组（n=23），对照组采用常规护理模式，观察组采用综合护理干预措施。对比分析两组术后8 h、24 h、48 h VAS评分，术前、术后4个月、术后12个月Harris评分及术后并发症发生情况。 结果 两组患者术前VAS评分、Harris评分相比，差异无统计学意义（P>0.05）；观察组术后8 h、24 h和48 h VAS评分均明显低于对照组，差异具有统计学意义（P<0.05）；观察组术后4个月和12个月的Harris评分显著高于对照组，差异具有统计学意义（P<0.05）。观察组术后并发症率13.0%，明显优于对照组的39.1%，差异具有统计学意义（P<0.05）。 结论 综合护理干预措施能显著缓解老年股骨颈骨折患者THA术后疼痛，提高术后髋关节功能，并降低术后并发症发生率，具有重要临床研究意义，值得进一步推广研究。

[关键词] 护理干预；股骨颈骨折；人工髋关节置换术

[中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701（2015）12-0147-03

Application and effect evaluation of comprehensive nursing intervention in elderly patients with artificial hip arthroplasty of femoral neck fracture

KANG Zhimin1 SUN Qicai2

1.Department of Orthopaedic， Shaoxing City Center Hospital in Zhejiang Province， Shaoxing 312030， China； 2.Department of Orthopaedic， Zhejiang Hospital， Hangzhou 311241， China

[Abstract] Objective To study the clinical application effect of the comprehensive nursing intervention measures in the elderly femoral neck fracture patients with artificial hip arthroplasty（THA）， to provide a reference value for clinical nursing intervention. Methods All 46 patients with femoral neck fracture were randomly divided into control group （n=23） and observation group （n=23）， the control group was given conventional nursing model， observation group was given comprehensive nursing intervention measures. Comparison of postoperative 8 h， 24 h， 48 hVAS score， preoperative and after postoperative 4 months， 12 months， Harris score and postoperative complications were observed. Results The difference of VAS score， Harris score was not statistically significant between the two groups at preoperative （P>0.05）；VAS scores in observation group at 8 h， 24 h and 48 h after operation was significantly lower than those in control group，the difference between the two groups was statistically significant （P<0.05）， and Harris score in the observation group at 4 months and 12 months postoperative was significantly higher than those of control group， the difference between the two groups was statistically significant（P<0.05）； postoperative complication rate was 13.0% in the observation group， significantly better than the 39.1% in the control group， the difference was statistically significant （P<0.05）. Conclusion Comprehensive nursing intervention can significantly decrease the incidence of postoperative complications and improve the postoperative hip joint function and quality of nursing， has important clinical significance， worthy of further dissemination of research.

[Key words] Nursing intervention；Femoral neck fracture；Artificial hip replacement

股骨颈骨折是一种常见的骨折类型，占全身骨折的2%～6%，而且随着我国步入老龄化社会，老年人活动范围增大，股骨颈骨折的发生率呈逐年增加趋势[1，2]。人工髋关节置换是目前治疗髋关节疾病有效的方法之一，其疗效已经得到越来越多骨科医生的肯定。随着人们对该技术的不断深入了解，也促进了技术的进步和发展，但是由于手术后患者不能立即下床活动，因此相对易引起患者术后包括脱位、松动、撞击、感染、骨溶解、金属过敏、神经麻痹、疼痛甚至是死亡等各种并发症[3，4]。围手术期的护理质量可直接影响THA的疗效，因此老年股骨颈骨折THA的围手术期护理受到临床的广泛关注[5]。本研究中笔者通过对23例股骨颈骨折THA患者实施综合护理干预，并与常规护理的23例患者对照，取得了满意的效果。现报……