雷磊 苏达明 赵军华

[摘要] 目的 探討经腹直肌外侧小切口入路治疗髋臼骨折的临床护理。 方法 回顾性分析我院2015年3月至2020年9月期间收治的64例经腹直肌外侧小切口入路治疗的髋臼骨折患者的临床资料，根据围手术期的护理措施将患者分为常规组和观察组，每组各32例，常规组采用常规围手术期护理，观察组采用微信建立的多学科合作综合护理模式对患者进行综合护理。比较两组患者术后12、24、36 h的疼痛视觉模拟评分（VAS），术后24周髋关节功能及患者满意度。 结果 观察组患者的术后12、24、36 h VAS评分均显著低于常规组，差异有统计学意义（P<0.01）;术后24周髋关节功能：常规组优良率为90.63%（29/32），观察组优良率为93.75%（30/32），两组之间差异无统计学意义（χ2=0.217，P=0.641），两组总体优良率92.19%（59/64），总优良率好。满意度评价：常规组满意度为85.94%（165/192），观察组为94.27%（181/192），观察组的满意度明显高于常规组，差异有统计学意义（χ2=7.477，P=0.006）。 结论 利用微信建立的多学科合作的综合护理模式在髋臼骨折患者的围手术期应用中取得了良好的效果，能显著改善患者围手术期的疼痛，提高患者满意度高，髋关节功能恢复好，值得临床推广。

[关键词] 髋臼;骨折;入路;围手术期;护理

[中图分类号] R473          [文献标识码] B          [文章编号] 1673-9701（2021）35-0183-04

Clinical care of acetabular fractures treated with small incisions through lateral-rectus approach

LEI Lei   SU Daming   ZHAO Junhua

Department of Orthopedics， Jingzhou Third People′s Hospital in Hubei Province， Jingzhou   434001， China

[Abstract] Objective To explore the clinical care of acetabular fractures treated with small incisions through lateral-rectus approach. Methods A retrospective analysis of clinical data of 64 patients with acetabular fractures treated with small incisions through lateral-rectus approach in our hospital from March 2015 to September 2020 was conducted. They were divided into the routine group （32 patients） and the observation group （32 patients）， according to perioperative care measures. The routine group were given routine perioperative care， and the observation group were given multidisciplinary cooperative comprehensive care model established by WeChat to provide comprehensive care for patients. The visual analogue scale （VAS） scores of pain at 12 h， 24 h， and 36 h after surgery， hip joint function and patient satisfaction at 24 weeks after surgery were compared between the two groups. Results The 12 h，24 h， and 36 h VAS scores in the observation group were significantly lower than those in the routine group，with statistically significant differences（P<0.01）. In terms of hip function at 24 weeks after surgery： the excellent and good rate in the routine group was 90.63% （29/32） and that in the observation group was 93.75%（30/32），without statistically significant difference（χ2=0.217， P=0.641）. The overall excellent and good rate in the two groups was 92.19%（59/64）， which was good. The satisfaction in the routine group was 85.94% （165/192）， and that in the observation group was 94.27% （181/192）. The satisfaction in the observation group was significantly higher than that in the routine group， with statistically significant difference（χ2=7.477， P=0.006）. Conclusion The multidisciplinary cooperative comprehensive care model established by WeChat achieves good results in patients with acetabular fractures in perioperative period. It can significantly relieve perioperative pain， improve patient satisfaction， and restore hip joint function. It is worthy of clinical promotion.

[Key words] Acetabulum; Fracture; Approach; Perioperative period; Care

我国交通事故、高处坠落等高能量创伤导致髋臼骨折的发生率呈逐年上升趋势，在创伤性骨折中占5%～8%[1]。髋臼的解剖结构特殊，手术难度较大，手术并发症较多，术后恢复周期较长[2]。髋臼骨折有多种手术入路可以选择，一项Meta分析表明[3]，与经典的髂腹股溝入路相比，改良Stoppa入路及腹直肌外侧入路在手术时间、术中出血量、骨折复位满意度及术后功能恢复方面有一定优势[4]。……