郭靓　李鑫

[关键词] 互联网+;延续护理;PFNA;Harris评分;改良Barthel指数

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）14-0185-04

Research on the application of internet plus transitional care after PFNA operation

GUO Liang1   LI Xin2

1.Department of Nursing， First People′s Hospital of Tianshui City in Gansu Province， Tianshui   741000， China; 2.Department of Orthopaedics， First People′s Hospital of Tianshui City in Gansu Province， Tianshui   741000， China

[Abstract] Objective To explore the application effect of internet plus transitional care after PFNA operation. Methods A total of 126 patients after undergoing PFNA operation from January 2018 to January 2019 were randomly divided into the observation group and the control group. The observation group was treated with internet plus transitional care， while the control group was treated with conventional nursing. Harris score， modified Barthel index （MBI）， satisfaction and incidence of complication were compared between the two groups. Results A total of 126 patients were followed up， and six months after discharge， the Harris score of the observation group was （89.34±8.31） points， which was significantly different from （81.26±10.12） points in the control group， with statistically significant difference（P<0.05）.The MBI score of the observation group was （88.67±6.63） points， which was higher than （80.79±8.72） points in the control group（P<0.05）. The satisfaction in the observation group was （96.4±1.3） points，which was higher than （90.6±1.5） points in the control group，with statistically significant difference between the two groups （P<0.05）. The incidence of complications in the observation group was 9.51%， which was significantly different from 20.63% in the control group， with statistically significant difference（P<0.05）. Conclusion Internet plus transitional care can promote postoperative recovery of patients after undergoing PFNA operation， improve their self-nursing ability， reduce their incidence of complications， and achieve high patients′ satisfaction.

[Key words] Internet plus; Transitional care; PFNA; Harris score; Modified Barthel index

隨着中国老年人口逐步增长，老年人因摔伤导致的股骨粗隆间骨折发生率明显上升，约占老年人全身骨折的21%[1]。老年股骨粗隆间骨折患者因身体机能下降，伴有多种基础疾病，治疗难度大。系统的护理、微创手术，减少并发症的发生是骨科医护一贯的目标[2]。目前临床上应用首选的是股骨近端抗旋髓内钉（Proximal femoral nail antirotation，PFNA）[3]。PFNA微创植入，创伤轻、切口小，明显缩短住院时间。但患者出院后康复和护理难以为继，严重影响治疗效果和患者健康[4]。如何解决治疗护理的“最后一公里”，延续护理应运而生。通过互联网+搭建的平台，使患者出院后系统的护理持续，解除了时间空间的阻碍，对促进患者恢复和提高生活质量有重大的意义[5]。其中微信是目前应用最为广泛的交流软件，通过多种方式实现时时沟通，依靠微信平台实施延续护理也越来越广泛[6]。2018年1月至2019年1月，我院对PFNA术后患者采用微信平台对PFNA术后患者进行延续护理，取得良好效果，现报道如下。

1 资料与方法

1.1 一般资料

纳入标准：①60周岁以上老年患者;②患者为单侧闭合股骨粗隆间骨折首次行PFNA治疗，未参与类似研究;③无认知障碍;④患者或家属能使用手机微信;⑤术后未出现其他严重疾病。排除标准：①年龄不足60周岁的转子间骨折患者;②精神异常无法正常沟通者;③手术禁忌明显未行手术治疗患者;④未按时访问平台，依从性差的患者[7]。最终纳入符合标准126例病例，并随机分为观察组及对照组，每组各63例。……