徐婉毅　肖粲　唐安邦　禤韵莹　李燕

【摘要】 目的：探讨老年肱骨近端骨折患者围术期实施综合性护理干预的临床应用效果。方法：选取2016年1月-2017年12月本院收治的40例老年肱骨近端骨折患者。按照随机数字表法将其分为对照组和试验组，各20例。两组均给予常规护理干预，研究组在此基础上给予综合性护理干预。比较两组干预前后的疼痛程度（VAS评分）、肩功能恢复情况（Constant-Murley评分）、心理状态（SDS、SAS评分）、生活质量评分及并发症情况。结果：研究组术后并发症发生率为15.00%，显著低于对照组的45.00%（P<0.05）;干预后，两组VAS、SDS、SAS评分均低于干预前，且研究组均低于对照组，差异均有统计学意义（P<0.05）;干预后，两组Constant-Murley、生活质量各维度评分均高于干预前，且研究组均高于对照组，差异均有统计学意义（P<0.05）。结论：老年肱骨近端骨折患者围术期实施综合性护理干预可降低患者术后并发症发生率及疼痛程度，改善患者心理状态，促进肩功能恢复，患者具有较高的生活质量。

【关键词】 综合性护理干预; 老年; 肱骨近端骨折; 围术期; 疼痛

【Abstract】 Objective：To explore the clinical effect of comprehensive nursing intervention on elderly patients with proximal humerus fracture during perioperative period.Method：A total of 40 elderly patients with proximal humeral fractures from January 2016 to December 2017 were selected.According to the random number table method，they were divided into control group and experimental group，20 cases in each group.They were given routine nursing intervention，and experimental group was given comprehensive nursing intervention on this basis.The pain degree（VAS score），shoulder function recovery（Constant-Murley score），mental state（SDS，SAS score），quality of life score before and after intervention，and complications between two groups were compared.Result：The incidence of postoperative complications in experimental group was 15.00%，significantly lower than 45.00% of control group（P<0.05）.After intervention，the scores of VAS，SDS and SAS in two groups were lower than those of before intervention，and experimental group were lower than those of control group，the differences were statistically significant（P<0.05）.After intervention，the scores of Constant-Murley and quality of life in two groups were higher than those of before intervention，and experimental group were higher than those of control group，the differences were statistically significant（P<0.05）.Conclusion：Perioperative comprehensive nursing intervention for elderly patients with proximal humerus fractures can reduce the incidence of postoperative complications and pain，improve the psychological status of patients，and promote the recovery of shoulder function，patients with high quality of life.

【Key words】 Comprehensive nursing intervention; Elderly; Proximal humeral fractures; Perioperative period; Pain

First-authors address：Guangzhou Orthopedics Hospital，Guangzhou 510045，China

doi：10.3969/j.issn.1674-4985.2019.11.025

老年人常伴有不同程度的骨質疏松，近年来，随着我国老龄化进程的不断发展，肱骨近端骨折发生率随之上升。由于肱骨近端骨折复杂多样，临床中常采用手术方式治疗。有研究表明，有效的护理干预在老年肱骨近端骨折患者围术期中应用可增强护理效果，改善预后[1]。为此，本研究将综合性护理干预用于老年肱骨近端骨折患者围术期中，探讨其临床应用价值。现报道如下。

1 资料与方法

1.1 一般资料 选取2016年1月-2017年12月本院收治的40例老年肱骨近端骨折患者。纳入标准：经CT、X线片或MRI检查后确诊;年龄≥60岁;Neer分型Ⅱ、Ⅲ、Ⅳ型。排除标准：合并血管或神经损伤;开放性骨折和病理性骨折;风湿性骨关节病;合并有其他脏器功能障碍或精神性疾病;存在基础病变无法耐受手术治疗。按照随机数字表法将其分为对照组和试验组，各20例。患者均签署知情同意书，经医院医学伦理委员会批准。……