“三防三位”针对性护理对人工髋关节置换术患者假体脱位的预防效果分析

田桂香

[摘要]目的 研究“三防三位”针对性护理对人工髋关节置换术（AHJR）患者假体脱位的預防效果。方法 选取2014年6月～2015年12月我院收治的AHJR患者414例作为对照组，予以常规护理。选取2016年1月～2017年7月我院收治的AHJR患者428例作为观察组，在常规护理的基础上予以“三防三位”针对性护理。比较两组术后3个月内假体脱位发生情况，护理前后焦虑、抑郁情况变化情况，以及护理前后生活质量变化情况。结果 观察组患者术后3个月内髋关节翻修术的假体脱位发生率明显低于对照组，差异有统计学意义（P<0.05），两组股骨颈骨折和股骨头坏死，以及先天性髋关节疾病的假体脱位发生率的比较，差异均无统计学意义（均P>0.05）。两组患者护理前的SAS及SDS评分比较，差异均无统计学意义（P>0.05）。护理后两组的SAS、SDS评分均分别明显低于护理前，且观察组低于对照组，差异均有统计学意义（均P<0.05）。两组护理前各项SF-36评分的比较，差异均无统计学意义（P>0.05）；护理后两组的各项SF-36评分均明显高于护理前（P<0.05），且观察组高于对照组，差异均有统计学意义（P<0.05）。结论 “三防三位”针对性护理对AHJR患者假体脱位的预防效果显著，有利于缓解患者焦虑、抑郁情绪，同时有效提高其生活质量，值得临床推广应用。

[关键词]人工髋关节置换术；假体脱位；三防三位；针对性护理；预防效果

[中图分类号] R473.6 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0176-04

Preventive effect analysis of "three prevention and three position " targeted nursing on prosthesis dislocation of patients with artificial hip joint replacement

TIAN Gui-xiang

Department of Nursing，Shangyou County Chinese Medicine Hospital of Ganzhou City in Jiangxi Province，Ganzhou 341200，China

[Abstract]Objective To study the preventive effect of “three prevention and three position” targeted nursing on prosthesis dislocation of patients with artificial hip joint replacement（AHJR）.Methods A total of 414 AHJR patients admitted to our hospital from June 2014 to December 2015 were selected as the control group and given routine care.A total of 428 AHJR patients admitted to our hospital from January 2016 to July 2017 were selected as the observation group，based on the conventional nursing，"three-prevention and three-prevention" targeted nursing was given.The incidence of endoprosthesis dislocation within 3 months after surgery，anxiety and depression before and after nursing，and quality of life before and after nursing were compared between the two groups.Results The incidence of prosthesis dislocation within 3 months after surgery in the observation group was significantly lower than that in the control group，the difference was statistically significant （P<0.05）.There was no statistically significant difference in the incidence of femoral neck fracture，femoral head necrosis and congenital hip joint disease between the two groups （P>0.05）.There was no significant difference in SAS and SDS scores between the two groups before nursing （P>0.05）.SAS and SDS scores of the two groups after nursing were significantly lower than those before nursing，and those in the observation group were lower than that of the control group，the differences were statistically significant（P<0.05）.There was no significant difference in SF-36 scores between the two groups before nursing（P>0.05）.The SF-36 scores of the two groups were significantly higher after nursing than before nursing，the differences were statistically significant（P<0.05），and those in the observation group were higher than the control group，the differences were statistically significant （P<0.05）.Conclusion The “three prevention and three position” targeted nursing has a significant preventive effect on prosthetic dislocation of AHJR，which is beneficial to relieve anxiety and depression of patients，and effectively improve patients satisfaction and quality of life，so it is worthy of clinical application.

[Key words]Artificial hip joint replacement；Prosthesis dislocation；Three prevention and three position；Targeted nursing；Preventive effect

人工髋关节置换术（artificial hip joint replacement，AHJR）是目前临床上应用于髋关节疾病中的主要治疗方式之一，但术后患者发生假体松动、脱位、异位骨化以及假体柄穿出骨皮质等一系列并发症的风险较高[1]。其中假体脱位属于髋关节置换术后发生率仅低于松动的并发症，不仅会给患者的身心造成极大的影响，同时在一定程度上延长治疗时间，增加治疗费用，甚至可能会导致髋关节功能损害[2]。因此，对接受AHJR治疗的患者进行围术期有效护理显得尤为重要。本文通过研究“三防三位”针对性护理对AHJR患者假体脱位的预防效果，旨在寻找最佳护理措施，现报道如下。