曾秋春 王湘勃

[摘要] 目的 改良股骨近端防旋髓内钉治疗股骨粗隆间骨折56例的护理干预。 方法 2018年11月~2019年11月将我院的56例股骨粗隆间骨折患者作为研究对象,将其按照入院顺序分为研究组与对照组,两组患者均采用改良股骨近端防旋髓内钉治疗,治疗后研究组给予综合护理干预,对照组给予常规护理干预,干预后评价两组临床治疗效果、疼痛程度、不良反应发生率及患者负性情绪变化情况。 结果 研究组手术切口愈合时间及住院时间显著低于对照组,差异有统计学意义。研究组疼痛程度低于对照组,差异有统计学意义。研究组不良反应发生率明显低于对照组,差异有统计学意义。研究组负性情绪低于对照组,差异有统计学意义。 结论 股骨粗隆间骨折患者采用改良股骨近端防旋髓内钉治疗期间,给予患者综合护理干预,既能提高护理效果,缓解患者疼痛,又能降低不良反应发生率,改善患者负性情绪,应被大力推广。

[关键词] 改良股骨近端防旋髓内钉;股骨粗隆间骨折;护理干预;护理效果

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701(2020)19-0159-03

Nursing intervention of modified proximal femoral anti-rotation intramedullary nail in the treatment of 56 cases of femoral intertrochanteric fracture

ZENG Qiuchun WANG Xiangbo

CITIC Huizhou Hospital of Huizhou City in Guangdong Province, Huizhou 516006, China

[Abstract] Objective To explore the nursing intervention of modified proximal femoral anti-rotation intramedullary nail in the treatment of 56 cases of femoral intertrochanteric fracture. Methods 56 patients with intertrochanteric femoral fractures in our hospital from November 2018 to November 2019 were selected as study object and divided into a study group and a control group according to the order of admission. Both groups of patients were treated with modified proximal femur anti-rotation intramedullary nail. The study group was given comprehensive nursing intervention after treatment, and the control group was given routine nursing intervention. After intervention, the clinical treatment effect, pain level, incidence of adverse reactions, and patients' negative emotional changes between the two groups were evaluated. Results The healing time of the surgical incision and hospitalization time in the study group were much lower than those in the control group, and the difference was significant. The pain degree in the study group was lower than that in the control group, and the difference was significant. The incidence of adverse reactions in the study group was significantly lower than that in the control group, and the difference was significant. The negative emotions in the study group were lower than those in the control group, and the difference was significant. Conclusion During the treatment of intertrochanteric fractures patients with modified proximal femoral anti-rotation intramedullary nails, comprehensive nursing intervention given to patients can not only improve the nursing effect, relieve patients 'pain, but also reduce the incidence of adverse reactions and improve patients' negative emotions. It should be vigorously promoted.

本研究结果显示,研究组手术切口愈合时间(13.45±0.41)d及住院时间(20.13±3.24)d,明显低于对照组(16.21±0.17)d、(24.34±1.36)d,差异有统计学意义;研究组不良反应发生率为3.57%,相较对照组的21.42%明显偏低,差异有统计学意义。在蒋小燕等[13]的研究中,研究组手术切口愈合时间及住院时间分别为(13.79±0.51)d、(20.83±3.69)d,不良反应发生率为4.25%,相较对照组结果偏低;本研究中研究组手术切口愈合时间、住院时间及不良反应发生率均低于对照组,与蒋小燕等[13]研究结果相似,具有可靠性。责任护士具体护理过程中首先应评估患者具体病情,随后根据患者病情给予术前护理、术中护理及术后护理,并为患者制定饮食方案,给予患者心理疏导。通过护理干预,可以明显改善患者不良情绪,提高患者满意度[14-15]。

综上所述,股骨粗隆间骨折患者采用改良股骨近端防旋髓内钉治疗期间,给予患者综合护理干预,既能提高护理效果,缓解患者疼痛,又能降低不良反应发生率,改善患者负性情绪,临床应大力推广及应用。

[参考文献]

[1] 张龙,申海龙,张磊. 微创股骨近端防旋髓内钉治疗老年股骨粗隆间骨折临床分析[J]. 海南医学,2016,27(2):299-301.

[2] 李晓峰. 股骨近端防旋髓内钉、动力髋螺钉内固定术治疗老年不稳定型股骨粗隆间骨折效果对比[J]. 山东医药,2016,56(26):83-85.

[3] 孙群周,阮成群,李光明,等. 重建股骨距与股骨近端防旋髓内钉治疗老年不稳定股骨粗隆间骨折的疗效比较[J]. 中国骨伤,2016,29(8):684-688.

[4] Weiguang Yu,Xinchao Zhang,Xingfei Zhu,et al. Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures:An outcome analyses with a minimum 4 years of follow-up[J].Bmc Musculoskeletal Disorders,2016,17(1):222.

[5] 刘宪昌. 体位对股骨近端防旋髓内钉(PFNA)内固定治疗不稳定股骨粗隆间骨折疗效的影响[J]. 创伤外科杂志,2016,18(10):620-621.

[6] 向忠,刘洪,李浩波,等. 股骨近端防旋髓内钉和动力髋螺钉治疗股骨粗隆间骨折的临床对比研究[J]. 中国现代医学杂志,2016,26(16):92-96.

[7] Anmol Sharma,Anisha Sethi,Shardaindu Sharma. Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw:A comparative study[J]. Revista Brasileira De Ortopedia,2017,53(4):477-481.

[8] 郝有亮,张志山,周方,等. 股骨近端防旋髓内钉固定治疗股骨反转子间骨折内固定失败的危险因素分析[J].中华创伤骨科杂志,2019,21(9):771-776.

[9] 莫华贵,黄远翘,陈元庄,等. 三种髓内固定技术治疗老年股骨粗隆间骨折对患者股骨头旋转与固定钉滑脱的影响[J]. 海南医学,2016,27(6):920-922.

[10] 范晓东,赵新国,张敬堂. PFNA与股骨头置换治疗高龄不稳定股骨粗隆间骨折的早期临床疗效对比[J]. 安徽医学,2016 37(8):1026-1028.

[11] Sampat S Dumbre Patil,Sachin S Karkamkar,Vaishali S Dumbre Patil,et al. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures[J]. Indian Journal of Orthopaedics,2016, 50(4):374.

[12] 华荣,顾军,倪英杰,等. 股骨近端防旋髓内钉、加压滑动鹅头钉和股骨近端锁定加压钢板治疗股骨粗隆间骨折的疗效比较[J]. 安徽医药,2016,20(9):1687-1690.

[13] 蒋小燕,袁亚娟. 股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的围术期护理[J]. 实用临床医药杂志,2016, 20(10):171-172.

[14] 王颖,冯香. 中药外敷在老年股骨粗隆间骨折患者术后护理中的应用效果[J]. 中华现代护理杂志,2016,22(25):3641-3643.

[15] 傅秀珍,陈梦丽. 快速周转护理模式在高龄股骨粗隆间骨折患者中的应用[J]. 实用医学杂志,2017,33(11):1876-1879.

(收稿日期:2020-03-06)