茅惠贤

[摘要] 目的 探讨家庭访视护理干预对老年脊柱骨折伴脊髓损伤患者负性心理、生活质量及身心健康的影响。 方法 将苏州大学附属第二医院130例老年脊柱骨折伴脊髓损伤患者随机分为观察组与对照组，各65例。对照组常规给予出院指导，观察组在此基础上由专业护理人员定期家庭访视。半年后比较两组患者负性心理、生活质量、身心健康以及并发症情况。 结果 出院后1个月与6个月，观察组患者SDS评分分别为（46.8±11.3）分与（38.5±6.9）分，显著性低于对照组的（54.0±10.2）分与（46.0±8.4）分（P < 0.05）；观察组患者SAS评分分别为（46.0±8.8）分与（36.4±9.2）分，显著性低于对照组的（52.7±9.4）分与（45.7±8.9）分（P < 0.05）。观察组患者各项日常生活活动能力评分均显著性高于对照组（P < 0.05）。观察组身心健康评分显著低于对照组（P < 0.05）。观察组肺部感染、压疮以及尿路感染等并发症发生率为27.7%，显著性低于对照组的53.9%（P < 0.05）。 结论 家庭访视护理干预可帮助老年脊柱骨折伴脊髓损伤患者进行规范化的康复治疗，可有效减少并发症的发生并提高患者的生活质量。

[关键词] 家庭访视；老年脊柱骨折伴脊髓损伤；负性心理；生活质量

[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210（2015）06（b）-0132-05

Effect of family visit nursing intervention on the negative psychology， life quality and physical and mental health of eldly patients with spinal fracture combined with spinal cord injury

MAO Huixian

West Eleven Ward， Department of Orthopaedics， the 2nd Affiliated Hospital of Suzhou University， Jiangsu Province， Suzhou 215000， China

[Abstract] Objective To explore the effect of family visit on the negative psychology， life quality and physical and mental health of eldly patients with spinal fracture combined with spinal cord injury. Methods 130 eldly patients with spinal fracture combined with spinal cord injury in the 2nd Affiliated Hospital of Suzhou University were divided into the observed group and the control group， each group had 65 cases. The control group was offered the conventional discharge guidance， while the intervention group was offered the family visit nursing. The negative psychology， life quality， physical and mental health and complications of spinal fracture combined with spinal cord injury patients of the two groups were analyzed. Results 1 month and 6 months after leaving hospital， the SDS scores of observed group were （46.8±11.3） points and （38.5±6.9） points， which were significantly lower than those of the control group， [（54.0±10.2）， （46.0±8.4） points] （P < 0.05）. The SAS scores of observed group were （46.0±8.8） points and （36.4±9.2） points， which were significantly lower than those of the control group [（52.7±9.4）， （45.7±8.9） points] （P < 0.05）. The quality of life scores in observed group were significantly higher than those of the control group （P < 0.05）. The physical and mental health scores of the observed group were significantly lower than those of the control group （P < 0.05）. The incidence of pulmonary infection， pressure ulcers and urinary tract infection in observed group was 27.7%， which was significantly lower than 53.9% of the control group （P < 0.05）. Conclusion Regular home visiting by the medical staff members can facilitate patients' rehabilitation and decrease their medical compliance， thus improving their life quality.

[Key words] Family visit； Eldly patients with spinal fracture combined with spinal cord injury； Negative psychology； Life quality

脊柱骨折伴脊髓损伤是一种较为严重的疾病，其不仅病程长，患者恢复较慢，同时也会造成患者不同程度的瘫痪[1-2]。在出院时患者往往并没有痊愈，易因出院后的护理不当与康复训练的错误而引发各种严重的并发症，降低生活质量甚至威胁患者的生命健康[3]。而对于老年人而言，由于身体各项机能均存在不同程度的退化，同时骨质疏松与各脏器疾病的患病率较高，不仅更易导致脊柱骨折伴脊髓损伤，同时恢复较慢。因此需要更为专业的康复指导与护理干预，以提高患者的生活质量，减少并发症的发生[4-5]。在本研究中，苏州大学附属第二医院（以下简称“我院”）为老年脊柱骨折伴脊髓损伤患者施行家庭访视护理，对患者进行康复指导以降低术后并发症的发生，提高了患者的生活质量。……