个案护理干预老年股骨转子间骨折并发症的临床应用研究

蓝婉婕 黄娟娟 韦贵珠 莫昌鸾 韦艳新 韩苗

【摘要】 目的 探討个案护理干预老年股骨转子间骨折并发症的临床应用效果。方法 将2017年7月～2019年2月骨科收治的老年股骨转子间骨折250例，随机分为研究组和对照组，对照组患者接受常规护理，研究组在此基础上实施个案护理干预。比较两组患者术后2 d和出院前的40项恢复质量评分，术前、术后7天、术后1个月、术后3个月生活自理能力评分（Barthel量表），以及住院天数、住院费用、并发症的发生率及护理服务满意度情况。结果 两组患者术前生活自理能力评分差异无统计学意义（P>0.05），术后评分研究组优于对照组（P<0.001），研究组患者术后恢复质量评分优于对照组（P<0.001），住院天数、住院费用均少于对照组（P<0.001），并发症的发生率明显低于对照组（P<0.01），护理服务满意度高于对照组（P<0.001）。结论 实施个案护理的干预可以降低老年股骨转子间骨折并发症的发生率，促进患者快速康复，提高术后恢复效果及生活自理能力，缩短患者住院日，减轻经济负担，提高患者对护理服务满意度。

【关键词】 个案护理;股骨转子间骨折;并发症

中图分类号：R473.6   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2020.07.008

【Abstract】 Objective To investigate the clinical effect of nursing intervention in complications in elderly patients with intertrochanteric fracture.Methods 250 elderly patients with intertrochanteric fractures admitted to the department of orthopedics from July 2017 to February 2019 were randomly divided into experimental group and control group.The control group were given routine nursing，and the study group were given case nursing intervention on this basis.The scores of 40 items of recovery quality 2 days after operation and before discharge，the scores of life self-care ability（Barthel scale） before operation，7 days after operation，1 month after operation and 3 months after operation as well as hospitalization days，hospitalization expenses，incidence of complications and satisfaction of nursing service were compared between the two groups.Results There was no statistically significant difference in preoperative self-care ability between the two groups（P>0.05）.The postoperative score of the study group was better than that of the control group（P<0.001）.The score of postoperative recovery quality in the study group was better than that in the control group（P<0.001），the hospitalization days and expenses were less than those of the control group（P<0.001），the incidence of complications was significantly lower than that of the control group（P<0.01），and the satisfaction of nursing service was higher than that of the control group（P<0.001）.Conclusion The implementation of case nursing intervention can reduce the incidence of complications in elderly patients with intertrochanteric fracture，promote the rapid recovery of patients，improve the postoperative recovery effect and self-care ability，shorten the length of stay，reduce the economic burden，and improve the satisfaction of patients with nursing services.

【Key words】 case nursing;intertrochanteric fracture;complication

股骨转子间骨折在西方又被称为成人最后一次骨折，许多老年人发生股骨转子间骨折之后就一病不起直至死亡。其实老年人发生股骨转子间骨折并不可怕，可怕的是长期卧床导致的肺部及泌尿系感染、压疮、下肢深静脉血栓等并发症[1]。因此，针对老年股骨转子间骨折这一特殊群体，应针对个体采取个性化的护理方式，早期预见性干预并发症的发生，才能提高护理质量及患者康复效果。个案护理通过充分地沟通交流促进个体对医疗护理服务的选择，以满足个体的健康需求，从而提高服务质量[2]。对老年股骨转子间骨折患者采取个案护理模式，使患者在治疗过程中得到连续性和整体性的护理服务，同时它强调并发症的预见性干预，定期监测并发症风险及预警征象，从而降低并发症的发生率。我院……