郭向丽

[摘要] 目的 探討股骨粗隆间粉碎性骨折老年患者进行围术期整体护理的效果。 方法 选取2017年1月至2018年1月在我院接受治疗的股骨粗隆间粉碎性骨折患者65例，分为参考组（n=32）与试验组（n=33），参考组行常规护理，试验组采用围术期整体护理路径，探讨不同护理方法的临床疗效，比较两组发生感染、疼痛、压疮等并发症率。 结果 随访6个月，参考组优12例，良15例，差5例，优良率为84.37%。试验组优20例，良11例，优良率为93.94%。两组优良率比较，差异有统计意义（χ2=10.240，P<0.05）。试验组未出现并发症，参考组1例感染，2例疼痛，并发症率为9.38%，试验组的并发症率低于参考组（χ2=10.370，P<0.05）。 结论 利用围术期整体护理对股骨粗隆间粉碎性骨折患者予以护理的效果明显，能够提高临床疗效，推荐在临床治疗中应用。

[关键词] 股骨粗隆间粉碎性骨折;围术期;整体护理;运动功能

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）08-0168-04

Application analysis of overall nursing during perioperative period in elderly patients with comminuted femoral intertrochanteric fracture

GUO Xiangli

Department of Orthopedics， Jincheng People′s Hospital in Shanxi Province， Jincheng   048000， China

[Abstract] Objective To explore the overall nursing during perioperative period in elderly patients with comminuted femoral intertrochanteric fracture. Methods A total of 65 patients with comminuted femoral intertrochanteric fracture who were treated in our hospital from January 2017 to January 2018 were selected as the study subjects. The patients were divided into the reference group with 32 cases and the experimental group with 33 cases. The reference group was treated with conventional nursing and the experimental group was treated with perioperative overall nursing. The clinical effects of different nursing methods were explored. At the same time， the incidence of infection， pain， pressure ulcers and other complications between the two groups were compared. Results They were followed up for 6 months. In the reference group， 12 cases were excellent， 15 cases were good， and 5 cases were poor， with the excellent and good rate of 84.37%.In the experimental group， 20 cases were excellent and 11 cases were good， with the excellent and good rate of 93.94%. There was a significant difference in the excellent and good rate between the two groups （χ2=10.240， P<0.05）. There was no complications in the experimental group. 1 case of infection and 2 case of pain in the reference group， with the complication rate of 9.38%. The complication rate in the experimental group was lower than that in the reference group （χ2=10.370， P<0.05）. Conclusion The use of perioperative overall nursing for patients with comminuted femoral intertrochanteric fracture is effective and can improve the clinical efficacy. It is recommended to be used in clinical treatment.

[Key words] Comminuted femoral intertrochanteric fracture; Perioperative period; Overall nursing; Motor function

股骨粗隆间骨折多发于老年群体中，因钙质流失等原因很容易引起骨质疏松，骨骼较为脆弱，在受到较强外力作用时就会发生骨折。而股骨粗隆间骨折的发生次数更多。股骨粗隆间骨折多为粉碎性骨折，目前需要进行手术治疗[1]，但是即使股骨粗隆间粉碎性骨折手术成功后，仍然不能表示功能可以完全恢复。患者需要长时间的功能恢复，必须掌握良好的护理干预措施，有助于提高術后的治疗效果。围术期整体护理的目的在于最大程度地恢复患者的股骨功能，减少对其生活的影响。在治疗过程中采取综合护理措施，能够提高临床疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取2017年1月至2018年1月我院接受治疗的股骨粗隆间粉碎性骨折患者65例。其中男46例，女19例。年龄66～85岁，平均（77.60±2.50）岁;均在我院接受了X线片、CT检查确诊病情。接诊时间为伤后1～3 h，平均（2.10±0.40）h;受伤原因：24例交通伤、10跌落伤、23例摔伤、8例其他伤。……