丁莉华

摘 要 目的：探讨优质护理在降低胸腰椎骨折术后压疮与尿路感染风险中的应用效果。方法：收集2016年1月至2018年2月接诊的40例患者，随机分为观察组和对照组各20例。对照组给予常规术后护理，观察组给予优质护理。观察两组视觉模拟疼痛（VAS）评分、下肢功能障碍（Oswestry）评分、压疮和尿路感染发生情况。结果：观察组术后及术后3个月VAS评分及Oswestry评分低于手术前和对照组（P<0.05）。观察组发生压疮1例（5.00%），尿路感染1例（5.00%），对照组分别为7例（35.00%）和6例（30.00%），观察组压疮和尿路感染发生率明显低于对照组（P<0.05）。结论：对于胸腰椎骨折术患者，优质护理能够减少术后疼痛，提高患者下肢功能，降低压疮和尿路感染发生率。

关键词 胸腰椎骨折；优质护理；压疮；尿路感染

中图分类号：R473.6 文献标志码：A 文章编号：1006-1533（2018）24-0031-02

Application of high quality nursing in reducing the risk of pressure ulcer and urinary tract infection after thoracolumbar fracture operation

DING Lihua

（Infectious Disease Department of Peoples Hospital of Wanan County， Jian 343800， Jiangxi Province， China）

ABSTRACT Objective： To explore the application effect of high quality nursing in reducing the risk of pressure ulcer and urinary tract infection after thoracolumbar fracture operation. Methods： Forty patients who were admitted from January 2016 to February 2018 were collected and randomly divided into an observation group and a control group with 20 cases in each group. The control group was given routine postoperative nursing， while the observation group was given high quality nursing. Visual analogue pain（VAS） score， lower limb dysfunction（Oswestry） score， and incidence of pressure ulcer and urinary tract infection were observed. Results： VAS score and Oswestry score were lower in the observation group after operation and 3 months after operation than those before operation and in the control group（P<0.05）. There were 1 case（5.00%） of pressure ulcer and 1 case（5.00%） of urinary tract infection in the observation group， and the control group had 7 cases（35.00%） and 6 cases（30.00%）， respectively. The incidence of pressure ulcer and urinary tract infection in the observation group was significantly lower than that in the control group（P<0.05）. Conclusion： For patients with thoracolumbar fracture operation， high quality nursing can reduce postoperative pain， improve the function of lower limbs， and reduce the incidence of pressure ulcer and urinary tract infection.

KEY WORDS thoracolumbar fracture； high quality nursing； pressure ulcer； urinary tract infection

胸腰椎骨折是一種严重创伤，会引起患者躯干负重功能的部分丧失甚至完全丧失，严重者发生瘫痪[1]。患者长期卧床，局部组织受压，增加了组织溃烂坏死的概率，发生压疮[2-3]。通常，患者手术后需常规留置导尿管，从而增加了发生尿路感染的风险[4]。对患者实施护理干预，减少不良情况的发生，对于提高患者的生活质量具有重要意义。本文报道对患者采取优质护理干预的效果。

1 资料与方法

1.1 一般资料

收集2016年1月至2018年2月接诊的40例胸腰椎骨折患者，均行手术治疗。采用随机号码表将患者分为观察组和对照组各20例。观察组中男性12例，女性8例，年龄19～60岁，平均（41.88±6.22）岁；交通伤10例，高处坠落伤4例，重物压伤6例。对照组中男性13例，女性7例，年龄20～60岁，平均（42.33±6.11）岁；交通伤11例，高处坠落伤4例，重物压伤7例。两组患者的基线资料差异无统计学意义（P>0.05）。所有患者均签署知情同意协议书。排除难以配合完成本研究及其他病症者。

1.2 方法

对照组给予常规术后护理，指导患者进行肢体护理、下肢活动护理、饮食护理、用药护理、并发症护理及健康教育、术后功能恢复等。……