张帆

[摘要]目的 研究根因分析法（RCA）對老年全髋关节置换术功能恢复的影响。方法 选取2015年1月～2017年1月在我院接受全髋关节置换术的72例老年患者，术后采取随机数字表法分成对照和治疗组，每组各36例。对照组进行常规护理，治疗组在常规护理的基础上，采用RCA进行护理，医护人员根据每一位患者的具体情况加以解决，采取心理干预、健康指导、并发症、患肢以及关节的康复训练等方面的护理。观察两组的髋关节术后差异进行评定，对日常患者生活能力Barthel指数，抑郁评分进行评定以及观察术后患者并发症的发生率，采用调查问卷的方式调查患者对护理的满意度。结果 治疗组在疼痛评分、功能评分、关节活动度评分以及髋关节Harris总评分上都高于对照组，差异均有统计学意义（P<0.05）；治疗组的Barthel指数高于对照组，治疗组的GDS抑郁量表评分低于对照组，差异均有统计学意义（P<0.05）；治疗组的并发症总发生率低于对照组，差异有统计学意义（P<0.05）；治疗组对护理的总满意度高于对照组，差异有统计学意义（P<0.05）。结论 术后采用RCA对老年全髋关节置换术进行护理，对其恢复起到了很好的疗效，缓解病症，提高了患者日常生活能力，还控制患者抑郁率的增加。

[关键词]根因分析法；老年患者；全髋关节置换术；功能恢复

[中图分类号] R473.6 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0199-04

[Abstract] Objective The effect of root factor analysis （RCA）on functional recovery of total hip arthroplasty in elderly patients was studied. Methods From January 2015 to January 2017， 72 elderly patients undergoing total hip replacement were selected and divided into the control group and the treatment group， according to random number table method. The control group was received routine nursing， the treatment group was adopted RCA method on the basis of routine nursing， the medical staff solved the problem according to the specific situation of each patient， and took psychological intervention， health guidance， complications， etc. Nursing care in rehabilitation training of affected limbs and joints. The difference between the two groups after hip operation was evaluated， the Barthel index and depression score of daily life were evaluated， and the incidence of postoperative complications was observed. Patients′ satisfaction with nursing was investigated by questionnaire. Results The scores of pain， function， range of motion and total score of Harris of hip joint in the treatment group were higher than those in the control group （P<0.05）； The Barthel index of the treatment group was higher than that of the control group， and the score of GDS depression scale in the treatment group was lower than that in the control group （P<0.05）； The total incidence of postoperative complications in the treatment group was lower than that in the control group （P<0.05）； The total satisfaction of the patients in the treatment group was higher than that in the control group （P<0.05）. Conclusion Postoperative geriatric total hip arthroplasty with RCA has played a good therapeutic effect on the recovery of the total hip arthroplasty， relieving the symptoms， improving the daily living ability of patients， and controlling the increase of patients′ depression rate.

[Key words] Root cause analysis； Elderly patients； Total hip replacement； Functional recovery

近年来，老年人身体因为在不同程度上出现钙流失的情况，导致身体功能正在逐渐衰退减弱，如若有不慎摔倒或是发生交通事故等突发情况发生，很容易发生髋部骨折，致使老年人行动不便，不仅给患者带来疼痛，还会使患者的生活质量受到严重的影响[1-2]。而手术治疗髋部骨折的多种方法中全髋关节置换术是目前在治疗老年全髋关节病症中最有效的方法。但通过观察以及反馈的信息，有25%～75%的老年髋部骨折的患者在术后恢复中并不能使日常的活动能力以及髋关节功能恢复到以前的水平[3]。……