郭秀芬

[摘要] 目的 觀察胫骨平台骨折患者实施临床护理路径的结果，分析临床护理路径对胫骨平台骨折患者术后康复的作用。 方法 针对该院于2017年8月—2019年6月收治的胫骨平台骨折患者，从中随机选择80例作为该次研究对象，试验组40例，对照组40例。对照组患者实施临床护理干预，试验组患者实施采用临床护理路径模式。观察与比较两组患者膝关节恢复情况、住院时间与费用、术后并发症发生率以及护理满意度。 结果 两组患者治疗后，试验组患者ROM角度（121.09±1.29）°、Lyshlom评分（70.05±5.37）分均优于对照组（110.71±1.46）°、（63.16±4.29）分，差异有统计学意义（t=3.891、4.201，P<0.05）。试验组患者住院时间（7.80±0.68）d、住院费用（3.54±1.03）万元少于对照组的（12.94±0.47）d、（4.71±1.06）万元，差异有统计学意义（t=4.018、3.766，P<0.05）。试验组术后并发症发生2.5%明显低于对照组20.0%，试验组术后护理满意度95.0%明显高于对照组77.5%，差异有统计学意义（χ2=6.793、7.833，P<0.05）。结论 对胫骨平台骨折患者实施临床护理路径，可以减少术后并发症的发生，促使患者膝关节功能恢复，缩短住院时间，对患者术后康复有着积极的作用。

[关键词] 胫骨平台骨折;临床护理路径;膝关节功能

[Abstract] Objective To observe the results of clinical nursing pathways for patients with tibial plateau fractures and analyze the effect of clinical nursing pathways on postoperative rehabilitation of patients with tibial plateau fractures. Methods A total of 80 patients with tibial plateau fractures treated in the hospital from August 2017 to June 2019 were random selected as the subjects of this study， 40 in the experimental group and 40 in the control group. Patients in the control group performed clinical nursing interventions， and patients in the test group performed clinical nursing pathway models. The knee joint recovery， length of hospital stay and cost， incidence of postoperative complications， and nursing satisfaction were observed and compared between the two groups. Results After treatment in the two groups， the ROM angle （121.09±1.29）° and Lyshlom score （70.05±5.37）points of the test group were better than those of the control group （110.71±1.46）° and （63.16±4.29）points， and the differences were statistically significant （t=3.891， 4.201， P<0.05）. The length of hospital stay （7.80±0.68）d and the cost of hospitalization （3.54±1.03）ten thousand yuan in the test group were less than the（12.94±0.47）d and（4.71±1.06）ten thousand yuan in the control group， and the differences were statistically significant （t=4.018， 3.766， P<0.05）. The incidence of postoperative complications in the experimental group was 2.5% significantly lower than that in the control group by 20.0%， and the postoperative nursing satisfaction rate in the experimental group 95.0% was significantly higher than that in the control group， which was 77.5%. The difference was statistically significant（χ2=6.793， 7.833， P<0.05）.  Conclusion The clinical nursing approach for patients with tibial plateau fractures can reduce the incidence of postoperative complications， promote the recovery of knee function， shorten the length of hospital stay， and have a positive effect on postoperative rehabilitation.

[Key words] Tibial plateau fracture; Clinical nursing pathway; Knee function

胫骨平台骨折是临床上不常见的一种骨科疾病，据统计胫骨平台骨折占所有骨折约1%，绝大多数骨折发生在内侧平台[1]。胫骨平台骨折大多是暴力伤害所致，例如高处跌落、交通事故等，属于关节内骨折。胫骨平台骨折患者关节面粉碎、膝关节软骨等组织受损、膝关节活动受限，严重影响了患者的日常生活。临床治疗胫骨平台骨折以手术治疗为主，但无论是传统术式还是近年来发展的微创术式，均属于有创手术，患者在术后均有可能发生感染或者应激现象，对患者术后康复产生不利影响。因此，需要对胫骨平台手术患者实施科学的护理干预。为了探究临床护理路径对胫骨平台骨折患者术后康复的作用，该文随机选择2017年8月—2019年6月该院80例胫骨平台骨折患者作为研究对象进行对比分析，现报道如下。……