邹慧　廖晗

[關键词] 下肢骨折手术;精细化护理;保暖护理;低体温;术后康复;生活质量

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）16-0172-04

Analysis of the application effect of warm nursing combined with refined nursing in patients with lower limb fracture surgery

ZOU Hui1， 2   LIAO Han1， 2

1.Department of Clinical Nursing， the Second Xiangya Hospital of Central South University， Changsha   410011， China; 2.Department of Anesthesiology， the Second Xiangya Hospital of Central South University， Changsha   410011， China

[Abstract] Objective To analyze and explore the effect of warm nursing combined with refined nursing in patients with lower limb fracture surgery. Methods Ninety-four patients with lower limb fractures who underwent surgical treatment in our hospital from February 2018 to February 2020 were selected as the research objects. According to the random number table， they were divided into the observation group and the control group， with 47 cases in each group. The control group was given refined nursing intervention， and the observation group was combined with warm nursing intervention on this basis. The incidence of postoperative hypothermia， chills and restlessness， complication rate， rehabilitation indicators， and quality of life scores were statistically compared between the two groups. Results The incidence of hypothermia， chills， and restlessness in the observation group within one day after surgery was 10.64% （5/47），8.52% （4/47）， and 8.52%（4/47）， which was lower than that in the control group [27.66% （13/47）， 25.53% （12/47）， 25.53% （12/47）]， and the difference between the groups was significant （P<0.05）. The incidence of complications in the observation group was 12.78% （6/47）， which was lower than 29.80% （14/47） of the control group， and the difference was statistically significant （P<0.05）. The time of getting out of bed， hospitalization time， fracture healing time， and weight-bearing time of the observation group were lower than those of the control group， and the difference was statistically significant（P<0.05）. At 3 months of postoperative follow-up， the scores of quality of life in the observation group were higher than those of the control group， and the difference between the groups was statistically significant（P<0.05）. Conclusion Warm nursing combined with refined nursing has a good effect in the perioperative application of patients with lower limb fracture surgery， which improves the postoperative warming effect of patients， reduces the incidence of hypothermia， chills， and restlessness， promotes the healing of fractures and the recovery of body functions， and improves the quality of life of patients. It is worthy of clinical application.

[Key words] Lower limb fracture surgery; Refined nursing; Warm nursing; Hypothermia; Postoperative rehabilitation; Quality of life

下肢骨折是骨折疾病中最为常见的一类骨折损伤性疾病，多由于直接的外界暴力打击或挤压伤所致的骨折，骨折类型以骨骼的横断、骨裂、粉碎骨折等为主要形式[1]。下肢骨折是骨折疾病中最为常见的类型，据临床不完全统计，约占各处骨折发病的30%～40%[2-3]。目前，主要治疗方法是通过手术的复位和固定，促进患者骨折的快速愈合和患肢功能的恢复。但在手术治疗后，患者需经历一个漫长的康复过程，术后易出现并发症和突发情况，影响患者术后康复进程。其中术后低体温是骨折术后常见的一种突发情况，其发生原因多为手术区皮肤蒸发、术中代谢、低温液体的输注带走了机体的部分热量所致[4-5]。因为术后发生低体温可引起一系列的不良事件，诸如外周血管收缩增加，循环阻力增大，心脑血管疾病增加，术后切口感染的发生几率增大等。为此，有必要在患者围术期给予相应的干预保护措施，降低术后低体温的发生给患者造成的危害[6]。在本研究中結合近期的临床实践，对纳入患者实施保暖护理联合精细化护理干预，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年2月至2020年2月在中南大学湘雅二医院进行手术治疗的94例下肢骨折患者进行研究。纳入标准[7]：①患者通过X线片确诊后均为下肢骨折;②均具有手术治疗的指征，并能耐受本研究的手术治疗方式;③患者一般资料完整;④患者无精神状态问题，能够有效配合手术治疗及术后康复治疗的实施;⑤患者本人或其家属签署书面知情同意书。……